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Civil Mediation Council

Workplace mediation enquiry form

We will treat all information you supply on this form in strict confidence.  We will contact you for an initial conversation (which will be free of charge, confidential and without obligation) to assess whether this is a suitable case for mediation, and whether you wish to contract us.  It will help us if you submit the form below before that conversation, but if you prefer you can email us with the essential details instead, or phone us on 08444 1555 34.

Your name    
Your role    
Organisation    
Email address    
Phone number(s)    
Address    
The parties to the dispute:   
1st person’s name    
2nd person’s name  
How do the parties’ job roles relate to each other?  
Brief details of the dispute or problems    
What interventions, if any, have been tried or started so far, to settle the dispute?    
Have both parties been offered mediation and agreed to try it?    
How did you hear of our mediation service?