Mediation Evaluation (For Parties Only) | Pdf Fpdf Doc Docx | Florida

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Mediation Evaluation (For Parties Only) | Pdf Fpdf Doc Docx | Florida

Mediation Evaluation (For Parties Only)

This is a Florida form that can be used for Mediation within Appellate Courts, District Courts Of Appeal, 5th District.

Alternate TextLast updated: 5/2/2006

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IN THE DISTRICT COURT OF APPEAL STATE OF FLORIDA FIFTH DISTRICT , Appellant(s), v. CASE NO. 5D , Appellee(s). _________________________/ MEDIATION EVALUATION For Parties Only Please take a few minutes to complete this form and return it to: Meredith G. Vincent, Mediation Coordinator Fifth District Court of Appeal 300 South Beach Street Daytona Beach, FL 32114 [Your responses will serve as a guide to the Court about changes or improvements whichneed to be made to the pilot program as it goes along, as well as whether it should becontinued at the end of the pilot year. Your responses are confidential and will not bepart of the appellate court file.] 1. WHAT KIND OF PROBLEM OR CASE WAS MEDIATED? (please select one) _____ Business Tort _____ Contract _____ Employment _____ Family matter (with children issues) _____ Insurance _____ Family matter (without children issues) _____ Real Estate _____ Personal injury/wrongful death _____ Other (please describe) ___________________________________________________________________ ____________________ ______________________________________________________________________________________ ________2. WAS YOUR APPEAL FROM A: ____ Summary Judgment ____ Final Judgment after jury trial ____ Final Judgment after non-jury trial ____ Other Final appealable order<<<<<<<<<********>>>>>>>>>>>>> 23. WAS YOUR PROBLEM OR CASE RESOLVED THROUGH MEDIATION AT THE APPELLATE LEVEL? ____ Yes, completely ____ No, made no progress ____ Made situation worse ____ Partially resolved (some issues stipulated to or resolved) ____ Issues or disputes directly involved in this appeal partially resolved ____ Issues or disputes not directly involved in this appeal resolved or partially resolved ____ Somewhat helpful in clarifying and simplifying issues for appeal ____ Other (please describe) __________________________________________ _ _________ _____________________________________________________________ _ ________________________________________________________________ 4. AR E ATTEMPTS TO SETTLE YOUR APPEAL STILL ONGOIN G? _____________ ___________________ _________________________________________________ __5. THE SERVICE PROVIDED BY THE MEDIATOR [NAME ___________________] ____ Helped a great deal ____ Made no difference ____ Helped some ____ Made things worse _________________________________ ____________________ _________________ 6. WOULD YOU RECOMMEND APPELLATE MED IATION? ____ Yes ____ No 7. PLEASE SUGGEST HOW YOU THINK WE CAN IMPROVE THE APPELLA TE MEDIATION PROGRAM. ____________________________________________ _ _____________________________________________________________________ ___ ________________________________________ ________________________________ _________________________ ____________________ _________________________ _______________ _____________________________________ Date Signature Parties should file this report with Meredith G. Vincent, Mediation Coordinator, Fifth District Court of Appeal, 300 S. Beach St., Dayto na Beach, FL 32114

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