Free Selection of and Arrangements with Mediator or Evaluator - Oklahoma

UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF OKLAHOMA ) ) ) ) ) ) )

Plaintiff(s) v.

Case No. CIV-

Defendant(s)

ADR SELECTION OF & ARRANGEMENTS with MEDIATOR or EVALUATOR Mediation Program: Selection of Mediator The Court has referred this case to mediation and in accordance with LCvR16.3, the following mediator is (please check the appropriate one): ____ selected by the parties from the list of the Court's panel of mediators; or ____ selected and agreed to by the parties (non-panel): Mediator Address for non-panel Mediators__________________________ __________________________ Signatures of Counsel: s/ Counsel for Plaintiff (Bar # s/ Counsel for Defendant (Bar #

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NOTE: Unless otherwise agreed at the status conference or directed by the Court, the SELECTION

AND ARRANGEMENTS must be made as soon as appropriate after the case is referred to ADR and no later than 30 days before the completion date established in the Scheduling Order or other order referring the case to ADR, submitted on this form and filed with the Court. For ADR information, see the Court's website at www.okwd.uscourts.gov. Arrangements for ADR Session Counsel have contacted the mediator or evaluator, the neutral has completed a conflicts check, and the following arrangements for the session have been made as follows: 200 , at .m. DATE and TIME: The session is set for PLACE: NOTE: An ADR session may be re-scheduled by the parties without leave of court anytime prior to the ADR Completion Deadline established by the Court.
This form shall be filed with the Court . A proposed order Appointing the ADR Neutral (see the attached form) based on this information shall be completed contemporaneously and submitted to the e-mail box of the assigned judge as set forth in the ECF Policy Manual.

Rev. 03/09