MEDIATOR EVALUATION FORM U.S. DISTRICT COURT DISTRICT OF COLUMBIA CIRCUIT Case Name: Mediator: Case Number: 1. Was an agreement reached? 2. How many sessions were held? 3. How much time was spent mediating this case? - How much time was spent mediating with attorneys and/or parties in person? - How much time was spent mediating by phone? 4. How much time did you have to complete mediation from the assignment of the case until mediator completion deadline? 5. Was this time adequate? Yes _____ hours hours _____ hours ______weeks No____ Study Number: Yes No
Please explain: ____________________________________________________________________ _________________________________________________________________________________ 6. Who attended the mediation session(s)? Sessions for Plaintiff: Party and Counsel Counsel Only Party Only Other ____ ____ 1st 2nd ____ ____ ____ ____ 3rd ____ ____ ____ ____ ____ Other ____ Sessions for Defendant: Party and Counsel Counsel Only Party Only ____ ____ 1st ____ ____ ____ ____ 2nd ____ ____ ____ ____ ____ 3rd ____
If parties were not present at the mediation, do you think their presence would have aided the process? Yes No Please explain: _______________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Please list the main issues in this case: ___________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ What motions, if any, were pending at the time this case entered mediation? ____________________ __________________________________________________________________________________
10. 11. 12. 13. 14.
Were there any intervener?
How much time did you spend preparing for the mediation?
Date of first mediation session: ________________________________________________________ Date of final mediation session: _______________________________________________________ Do you think mediation was an appropriate technique for this case? Yes No
If not, why? _______________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 15. The Circuit Executive's Office is trying to classify mediated cases by type. Please check the category that best describes this case. Contract Constitutional torts (prisoner petitions) Constitutional torts (Other) Employment (incl. civil rights) Civil Rights (other than employment) Fraud Malpractice Patent/Trademark/Copyright Personal Injury (Auto) Personal Injury (Other Property Damage Regulatory/Public Policy
If you cannot decide how to categorize the case or if it does not fall into any of the categories listed, please write a one or two sentence description. _______________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 16. Any other comments about the case or program may be written below:
At the completion of the mediation process, please return this evaluation in the returned envelope to: The Mediation Program, Room 4826, E. Barrett Pretty man U.S. Courthouse 333 Constitution Avenue, NW, Washington, D.C. 20001