Georgia > Local County > 7th District > Office Of Dispute Resolution
Civil And Domestic Mediation Scheduling Form - Georgia
| Civil And Domestic Mediation Scheduling Form Form. This is a Georgia form and can be used in Office Of Dispute Resolution 7th District Local County . |
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Office of Dispute Resolution SEVENTH JUDICIAL ADMINISTRATIVE DISTRICT P.O. BOX 963 CARTERSVILLE, GA 30120 www.7jad.com PHONE: (770) 387-4820 TOLL FREE: (877) 655-6865 FAX: (770) 387-5479 Civil and Domestic Mediation Scheduling Form STEP ONE Civil Action #: County: vs Location of Mediation: Time of Mediation: Style of Case: Name of Mediator: Date of Mediation: STEP TWO PLAINTIFF'S DATA Name: (Last, First MI) Mail Address City, State and Zip Phone Attorney's Name City, State and Zip Phone / Fax DEFENDANT'S DATA Name: (Last, First MI) Mail Address City, State and Zip Phone Attorney's Name City, State and Zip Phone / Fax STEP THREE No unilateral scheduling is permitted. By signing below, I am stating that the choice of mediator, date, time, and location listed above is the result of a mutual decision made between Plainiff(s). Defendant(s), and Mediator. Print Name: (Last, First MI) Attorney Office Signature Required / Date Phone Please give a brief description of any special circumstances. It is essential that copies of all documents bearing on issues to be resolved be brought to the mediation session (financial, medical, business, etc.) STEP FOUR Domestic Relations Only (please circle appropriate response) Divorce: Modification: Alimony / Child support / Custody / Debt Division / Property Division Alimony / Child Support / Custody / Visitation Are there concerns of abuse (spouse, child, substance, etc) that are alleged or otherwise indicated? Y / N Services are provided and admissions/referrals are made without regard to race, color, religious creed, ancestry, gender, sexual orientation, disability, age or national origin. Complaints of discrimination may be filed with the Seventh Administrative District Office. American LegalNet, Inc. www.FormsWorkFlow.com
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