Free ADR Report - New Hampshire

THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us

Court Name: Case Name: Case Number:
(if known)

ADR REPORT*
1. Name of Mediator: 2. Date of Mediation Session: 3. Periodic Mediation Report: Parties have agreed to ongoing mediation. The next mediation date is:

4. Final Mediation Report: Case settled prior to mediation session. Case may be appropriate for mediation but not with this mediator due to a conflict of interest or incompatibility between mediator's strengths/style and parties' needs. Case settled during mediation session. Parties were encouraged to seek legal review. A written agreement, covering all essential issues signed by the parties: is attached OR will be submitted to the court within 30 days.

Case settled in part. Parties were encouraged to seek legal review. A written partial agreement, covering essential issues and signed by the parties: is attached OR will be submitted to the court within 30 days.

The following issues were not resolved:

Case did not settle. The following parties failed to appear: I hereby certify that a copy of this report was mailed/given to the following attorneys of record and/or pro se parties:
Date Mediator

Please file this form at the Court within 3 days of the mediation session. *This Form may also be used to report the results of Neutral Evaluation and Arbitration by filling-in the information applicable to the particular dispute resolution process used, along with the pertinent information about the case and final disposition ( and documents) if any.

NHJB-2488-S (01/02/2008)

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