Parent/Guardian Mediation Information Form Home Parent/Guardian Mediation Information Form Parent/Guardian Mediation Information Form Parent/Guardian Mediation Information Form Name of Person Completing this Form* First Last Relationship to Student Email* PhoneStudent Name* First Last Mediation File Number Will parent/guardian be represented by an attorney at this mediation?NoYesIf yes, please provide attorney name and contact information.Please choose which format you prefer for your mediation session.online video conferencephone (audio-only)in-personMediation can be in-person*, through online video conferencing, or by phone. When mediation is not in-person, using video conferencing (example: Zoom) may help to improve communication. However, it is up to the parties to determine which format will work best for them. *Due to the COVID-19 pandemic, in-person mediation may not be available. Scheduling Scheduling the mediation should be done through the parent. Scheduling the mediation should be done through the attorney. Please provide multiple dates and times for the mediation. Dates should be at least a week or more in advance.Please write in the name, relationship to student, phone number, and email address of all participants you will be bringing to your mediation. To support a productive process, ODR suggests each party brings no more than three participants; however, it is up to you to determine who will participate in the mediation. The names of your participants will be provided to the other party; the phone number and email address of participants will be provided to the mediator only, in case of technology issues during the mediation.
