Report Of Mediator | Pdf Fpdf Docx | New York

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Report Of Mediator | Pdf Fpdf Docx | New York

Last updated: 10/22/2025

Report Of Mediator

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Description

REPORT OF MEDIATOR. This form is used by court-appointed or roster mediators in New York State to report the outcome of a referred case. It captures basic case details and session logistics, including referral date, session dates, number of sessions, and whether the mediation occurred in person, by video, or by telephone. The mediator selects checkboxes to indicate whether the matter settled fully, settled in part, did not settle, resolved before mediation, involved non-participation, a conflict of interest, or was otherwise unsuitable for mediation. The form ends with the mediator’s signature and a reminder not to include substantive case information. Parties are directed to file any settlement or discontinuance with the court. www.FormsWorkflow.com

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