Georgia > Local County > 7th District > Office Of Dispute Resolution
Attorney Referral Form - Georgia
| Attorney Referral 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 Attorney Referral Form DATE: ____________________ Please note that CASE ______-CV- ____________________, ( ______________________ County) ___________________v. ____________________ has not been referred to mediation by the Seventh Judicial Administrative District ADR Office. It is possible that this case is appropriate for mediation but our office does not yet have record of it. If all parties and attorneys involved in this case feel that this case is appropriate for mediation, this form may be completed and faxed back to the ADR office. Please note that cases with parties living out of state are not required to mediate. All parties and attorneys involved agree to mediation in this case. YES All defendants in this case have been served. NO YES NO Service date _______ Answer date _______ NO NO Is there any violence in this case? If yes, has a TPO been filed? If already scheduled with a mediator, all parties, attorneys and mediator involved in this case agree to the choice of mediator, location, date and time. Plaintiff's Full Name________________________________________ Attorney Info (Or Plaintiff info if Pro Se) Name______________________________________________________ Mailing Address _________________________________________________ Phone _______________ Fax ______________ Defendant's Full Name________________________________________ Attorney Info (Or Defendant info if Pro Se) Name______________________________________________________ Mailing Address _________________________________________________ Phone _______________ Fax ______________ All answers to questions listed above are true. YES YES YES NO N/A Signature (Required) ______________________ Name (Printed) __________________________ The ADR Office will contact you via fax or mail regarding whether or not this case has been approved to mediate. You will receive a Referral to Mediation or a notice informing you that this case was not found to be appropriate for mediation. If the ADR Office finds that this case is not appropriate for mediation, it will be the responsibility of the attorneys and parties involved in the case to cancel with the mediator at least 48 hours prior to the mediation if the attorneys or parties have already scheduled a session with a mediator. Otherwise the mediator may charge a two-hour cancellation fee. 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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