E99102BF-B146-146D-35DFAF9763C1170B.pdf
PDF 2 MB Posted
- Solicitation number
- RFP 2026-09-08
- Issued by
- Franklin County, Ohio
About this file
This is a Mediation Status Update form from the Franklin County Court of Common Pleas, Division of Domestic Relations and Juvenile Branch in Ohio. The document serves as a template for documenting the status and outcomes of mediation sessions in domestic relations and juvenile cases. The form is designed to track attendance of relevant parties including plaintiffs, defendants, guardians ad litem (GAL), and third parties, noting whether each participant appeared or failed to appear (FTA) at scheduled mediation sessions. The document provides fields for recording case identification information and allows mediators to document whether mediation sessions are ongoing with subsequent sessions scheduled, or terminated based on various outcomes including case unsuitability for mediation, party non-participation, failure to appear, or the achievement of no agreement, partial agreement, or full agreement among the parties.
The form includes options for documenting whether mediation services are assisting with pro se (self-represented) Agreed Entry preparation and contains fields for appointment dates, mediator comments, and date preparation signatures. This is a blank template form (eJU6253/DR6253 02-2025) with multiple checkboxes and fill-in fields in an editable format, intended for use by the Franklin County Mediation Services and Dispute Resolution Department to standardize documentation of mediation case outcomes and next steps, including referrals to court dates, counsel, or self-help centers.
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Text version
IN THE COURT OF COMMON PLEAS, FRANKLIN COUNTY, OHIO
FRANKLIN COUNTY DIVISION OF DOMESTIC RELATIONS AND JUVENILE BRANCH
MEDIATION STATUS UPDATE
Case #:
Plaintiff / Petitioner / In the Matter of:
Defendant(s) / Respondent(s):
GAL / 3rd Parties:
Mediation Session(s)
Plaintiff Appeared ___________________________________ FTA ________________
Defendant 1 Appeared ___________________________________ FTA ________________
Defendant 2 Appeared ___________________________________ FTA ________________
GAL / 3rd Party 1 Appeared ___________________________________ FTA ________________
3rd Party 2 Appeared ___________________________________ FTA ________________
MEDIATION OUTCOME
Mediation process ongoing:
☐ Initial / ☐ Subsequent mediation session scheduled for ________________________________________
Mediation process terminated:
☐ Case not suitable for mediation.
☐ __________________ failed to participate in mediation intake and/or failed to schedule mediation session.
☐ One or more parties/necessary participants failed to appear for scheduled mediation session (see above).
☐ No agreement in mediation.
☐ Partial agreement in mediation.
☐ Full Agreement in mediation.
The parties have been advised to take the memorandum of agreement to their next court date, seek counsel to prepare the Agreed Entry, or inquire with the self-help center for assistance.
☐ Full Agreement in mediation.
Mediation Services is assisting with pro se Agreed Entry. Appointment Date: _________________________
☐ Other/Comments: _______________________________________________________________
Date Prepared Mediator/Dispute Resolution Department
(eJU6253/DR6253 02-2025)
Attachment D
| Case: |
| Plaintiff Petitioner In the Matter of: |
| Defendants Respondents: |
| GAL 3rd Parties: |
| fill_2: |
| fill_4: |
| fill_6: |
| fill_8: |
| fill_10: |
| Initial: Off |
| Subsequent mediation session scheduled for: Off |
| Case not suitable for mediation: Off |
| One or more partiesnecessary participants failed to appear for scheduled mediation session see above: Off |
| No agreement in mediation: Off |
| Partial agreement in mediation: Off |
| Full Agreement in mediation: Off |
| Full Agreement in mediation_2: Off |
| OtherComments: Off |
| failed to participate in mediation intake andor failed to schedule mediation session: |
| undefined_2: |
| undefined_3: |
| MediatorDispute Resolution Department: |
| Check Box1: Off |
| Check Box2: Off |
| Check Box3: Off |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
| Check Box7: Off |
| Check Box8: Off |
| Check Box9: Off |
| Check Box10: Off |
| Check Box11: Off |
| clear: |
| print: |
| save as: |
| Date12_af_date: |
| Date13_af_date: |
| Date14_af_date: |
| Date15_af_date: |
| Date16_af_date: |
| Date17_af_date: |
| Date18_af_date: |
| Date19_af_date: |
File details come from the government source that posted it. Updated .