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Staff/Board
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Privacy Policy
Resources
Mediation
About Mediation
Why Mediate?
Divorce/ Family Mediation
Domestic Mediation Quesitonnaire
Community Mediation
General Community Mediation Questionnaire
Court Mediation
Getting Started
Apply for Free/Reduced Fees
Make a Payment
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Informational Videos
Getting Started
Resources
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Get Involved
Volunteer
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About Us
Services
Mediation
Restorative Conferencing
Conflict Coaching
Facilitation
Training
Make a Payment
Programs
Landlord & Tenant
Community Conversations
Leadership
Staff/Board
Our Team
Privacy Policy
Resources
Mediation
About Mediation
Why Mediate?
Divorce/ Family Mediation
Domestic Mediation Quesitonnaire
Community Mediation
General Community Mediation Questionnaire
Court Mediation
Getting Started
Apply for Free/Reduced Fees
Make a Payment
Landlord & Tenant
Informational Videos
Getting Started
Resources
Community Conversations
Get Involved
Volunteer
Donate Financially
Menu
About Us
Services
Mediation
Restorative Conferencing
Conflict Coaching
Facilitation
Training
Make a Payment
Programs
Landlord & Tenant
Community Conversations
Leadership
Staff/Board
Our Team
Privacy Policy
Resources
Mediation
About Mediation
Why Mediate?
Divorce/ Family Mediation
Domestic Mediation Quesitonnaire
Community Mediation
General Community Mediation Questionnaire
Court Mediation
Getting Started
Apply for Free/Reduced Fees
Make a Payment
Landlord & Tenant
Informational Videos
Getting Started
Resources
Community Conversations
Get Involved
Volunteer
Donate Financially
Search
Close this search box.
Donate
General Community Mediation Questionnaire
General Community Mediation Questionnaire
General Community Mediation Questionnaire
Mediation is a process where those involved in a dispute meet with a neutral third party- the mediator- who will help facilitate a dialogue in order to work together to resolve the conflict. In mediation each side tells their story and together, assisted by the mediator, create an agreement to meet their needs. The mediator does not make decisions. Research indicates that participants in mediation are more likely to follow through on agreements since they have actively participated in creating the agreement. Mediation is both voluntary and confidential.Please fill out the form below to start the mediation process at MMC.
Name
*
Phone Number
*
Address
ZIP Code
Email Address
*
Will you be Using an Attorney at Mediation?
Yes
No
Maybe
Other
If Other, Please Explain
If you are using an attorney please provide their name and phone number below.
Contact Information for Other Part
Name
*
Phone Number
Phone
Address
Address
Address
Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Côte d'Ivoire
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Email Address
*
What Brings you to Mediation?
Landlord/Tenant
Business
Neighbor
Roommate
Debt
Employment
Property
Other
Other
What do you hope to accomplish through mediation?
Please describe the issue/conflict below
Please indicate days and times when you are available to mediate.
How did you hear about Mountain Mediation Center
Word of Mouth
Website
Social Media
Other
Other
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