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Mediation Questionnaire - Florida
| Mediation Questionnaire Form. This is a Florida form and can be used in Mediation 5th District District Courts Of Appeal Appellate Courts . |
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IN THE DISTRICT COURT OF APPEAL OF THE STA TE OF FLORIDA FIFTH DISTRICT , Appellant, v. CA SE NO. 5D (Lower Court) Co. No. , Appellee. __________________________/ DATE: MEDIATION QUESTIONNAIRE * This questionnaire is sent to obtain information for the Courts use in determiningwhether this case is appropriate for appellate mediation. Pursuant to administrative order,copy enclosed, each party is ordered to file a completed questionnaire with Penny H.Cooper, Court Mediation Coordinator, Fifth District Court of Appeal, 300 S. Beach St.,Daytona Beach, FL 32 114, within ten (10) days of the date of the Courts acknow ledgment of the notice of appeal with a copy served on opposing counsel (except for the Confidential Statement Regarding Appropriateness of Appellate Mediation,which is only to be filed with the Mediation Coordinator of the court). FAI LURE T O RETURN QUESTI ONNAI RE AND CONFI DENTI AL ST ATEMENT MAY RESUL T IN SANCTI ONS<<<<<<<<<********>>>>>>>>>>>>> 2 Appellant(s) Attorney (Lead Counsel): Appellee(s) Attorney (Lead Counsel): Address (Lead Counsel): Address (Lead Counsel): Telephone: Telephone: Fax: Fax: E-Mail: E-Mail: Florida Bar No: Florida Bar No.: NATURE OF THE CASE _____ Business Tort _____ Contract _____ Employment _____ Family matter (with children issues) _____ Insurance _____ Family matter (without children issues) _____ Real Estate _____ Personal injury/wrongful death _____ Other (please describe) ISSUES ON APPEAL (To be completed by Appellants/Cross-Appellants only): Describe each expected issue on appeal as now known and the standard of review whichwill be applicable to each issue (completion of the questionnaire will not limit issues whichmay be raised in the briefs). MEDIATION Was the case mediated at the trial level? Yes No Has the case been mediated since entry of the order appealed? Yes No 2 <<<<<<<<<********>>>>>>>>>>>>> 3 - NOTICE - You are hereby given an extension to file your directions to the clerk and court reporter,upon your receipt of this form. If appellate mediation is ordered in this case, you will be givenan automatic extension of the deadlines for preparation of the transcript, preparation of the recordand filing of briefs, said time to run from the date of the notification from the Court thatmediation is ordered until 10 days after mediation has concluded . [Mediation session hasconcluded with either an impasse or full or partial settlement]. The court will send a letter ofinstruction if mediation is not ordered in this case. (It is the intention of the Court that the mediation process will not substantially slow down theappellate process. However, the above extensions will give the parties the opportunity to save thecosts of the record and brief preparation, if mediation is successful. Accordingly, additionalextensions of deadlines pending mediation will normally not be granted absent stipulation of theparties and court order). Date Lead Counsel For: CERTIFICATE OF SERVICE (Counsels Certificate of Service that complies with Florida Rule of Appellate Procedure 9.420( c) must be attached t o this Questionnaire) 3
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