Please fill out the below form to schedule a mediation with the ADR Coordinator of Lakeside Mediation.
All fields are required.
Name:
Assistant's Name:
Firm/Company:
Phone Number:
Fax Number:
Email:
Date(s) of Interest:
Full Day / Half Day:
# of Parties:
Mediator Preference :
(Eric Galton, Ben Cunningham, Greg Bourgeois, Pat Hazel, David Moore, or Clyde Oldham)
Nature of Case:
Style of Case:
If you would like to schedule a mediation by some other means, please
contact
the ADR Coordinator:
