36C10X20R0022-006.pdf

My experience with the mediation process:

The scale shown below is used for your responses. Please do not provide your name or identify specific issues in controversy discussed during the mediation.

MEDIATION PROCESS ASSESSMENT - PARTICIPANT/REPRESENTATIVE

VA FORM

JUL 2011 0890a

PLEASE IDENTIFY YOUR ROLE IN THIS PROCESSCASE NUMBER

2 1

I received sufficient information to understand the process prior to the session.

The right parties were at the table.

The mediation environment (location, room temperature, seating) was comfortable.

I am satisfied with the timing of the mediation (the time it took to get arranged and initiated, and how long to complete the mediation).

The mediator explained the mediation process before we started.

The mediator explained any conflicts or potential conflicts of interest.

The mediator was professional.

The mediator did not show favor to either side.

The mediator honored any requests I made for confidentiality during mediation.

The mediator avoided offering a legal opinion in this case.

The mediator allowed me to bring out all the relevant issues.

The mediator helped us to generate realistic options.

The mediator helped the parties work through issues and move toward closure.

I would recommend this mediator to others for mediation.

The outcome was the best for my situation (even if no resolution is reached).

I would recommend mediation to others.

Overall, I am satisfied with the mediation process.

Mediation helped me to be better aware of the other party's concerns.

Mediation helped the other party to be better aware of my concerns.

This mediation will improve working relationships in my workplace.

21. Comments (Write on the back of the form if necessary):

During the past year, did you participate in ADR awareness training? YES NO

5 - Strongly Agree 4 - Agree 3 - Neutral 2 - Disagree 1 - Strongly Disagree

Now that mediation is complete, please help improve the mediation program by taking a few minutes to complete this assessment.

INITIATOR

INITIATOR ATTY/REP

RESPONDENT

RESPONDENT ATTY/REP

NON-PARTY PARTICIPANT

A1

A2

A3

A4

A5

P

Line item 20 Line item 7 Line item 1 My experience with the mediation process:

My experience with the mediation process:

Line item 19 The scale shown below is used for your responses. Please do not provide your name or identify specific issues in controversy discussed during the mediation.

The scale shown below is used for your responses. Please do not provide your name or identify specific issues in controversy discussed during the mediation.

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MEDIATION PROCESS ASSESSMENT - PARTICIPANT/REPRESENTATIVE

MEDIATION PROCESS ASSESSMENT - PARTICIPANT/REPRESENTATIVE

VA FORM

JUL 2011

V.A. Form 0 8 9 0 a, JULY 2011 0890a

PLEASE IDENTIFY YOUR ROLE IN THIS PROCESS

PLEASE IDENTIFY YOUR ROLE IN THIS PROCESS

CASE NUMBER

Line item 2 Line item 3 Line item 4 Line item 5 Line item 6 Line item 18 Line item 17 Line item 16 Line item 15 Line item 14 Line item 13 Line item 12 Line item 11 Line item 10 Line item 9 Line item 8 I received sufficient information to understand the process prior to the session.

The right parties were at the table.

The mediation environment (location, room temperature, seating) was comfortable.

I am satisfied with the timing of the mediation (the time it took to get arranged and initiated, and how long to complete the mediation).

The mediator explained the mediation process before we started.

The mediator explained any conflicts or potential conflicts of interest.

The mediator was professional.

The mediator did not show favor to either side.

The mediator honored any requests I made for confidentiality during mediation.

The mediator avoided offering a legal opinion in this case.

The mediator allowed me to bring out all the relevant issues.

The mediator helped us to generate realistic options.

The mediator helped the parties work through issues and move toward closure.

I would recommend this mediator to others for mediation.

The outcome was the best for my situation (even if no resolution is reached).

I would recommend mediation to others.

Overall, I am satisfied with the mediation process.

Mediation helped me to be better aware of the other party's concerns.

Mediation helped the other party to be better aware of my concerns.

This mediation will improve working relationships in my workplace.

This mediation will improve working relationships in my workplace.

21. Comments (Write on the back of the form if necessary):

During the past year, did you participate in ADR awareness training?

5 - Strongly Agree 5 - Strongly Agree 4 - Agree 4 - Agree 3 - Neutral 3 - Neutral 2 - Disagree 2 - Disagree 1 - Strongly Disagree 1 - Strongly Disagree Now that mediation is complete, please help improve the mediation program by taking a few minutes to complete this assessment.

Now that mediation is complete, please help improve the mediation program by taking a few minutes to complete this assessment.

INITIATOR

INITIATOR ATTY/REP

RESPONDENT

RESPONDENT ATTY/REP

NON-PARTY PARTICIPANT

A1 A2 A3 A4 A5 P