Please confirm all scheduling information with the ADR Coordinator at (512) 477-9300 or
gcb@lakesidemediation.com
prior to submitting this form.
Case Style:
Mediation date:
(8:30 am, 12:00 noon or 3:30 p.m.)
Location:
Lakeside Mediation Center
Please check the assigned mediator:
Eric Galton
Ben Cunningham
Greg Bourgeois
David Moore
Pat Hazel
Karin Crump
Steve Wagh
Please fill in all of the requested information from your perspective and based on your best knowledge:
A list of the individuals who will be in your party during the mediation (It is imperative that party representatives have full authority to settle and that all persons necessary to the decision to settle are available for the mediation)
A statement of the nature of the case and issues:
(Please check this box if liability will not be contested for the purposes of this mediation)
Total Actual damages:
Uncontested: $
Contested: $
Brief explanation of why these damages may be in dispute:
History of settlement offers/demands:
Confidential assessment of settlement range (high/low) from your perspective (optional):
Concise statement regarding any dynamics (factual, legal, emotional, and practical) that you believe may affect the settlement process
