Free Statewide Mediation Attorney Questionnaire - New Jersey

State of New Jersey

FOR OFFICE USE ONLY

DATE RECEIVED:

LITIGANT QUESTIONNAIRE
DATE ENTERED ­ AOC:

Statewide Civil, General Equity and Probate Mediation Program
DIRECTIONS: This form is to be completed by the litigant at the conclusion of mediation.
CASE DOCKET NUMBER COUNTY DID YOU PARTICIPATE IN MEDIATION AS OR ON BEHALF OF THE PLAINTIFF OR DEFENDANT? DID YOU HAVE FULL AUTHORITY TO ENTER INTO A SETTLEMENT IN THE MEDIATION OF THE CASE? plaintiff defendant

THE MEDIATOR FOR THIS CASE WAS SELECTED BY:

parties/attorneys

court/judge

yes

no

DO YOU THINK THE MEDIATOR IN THIS CASE: yes yes no no Gave you a full opportunity to convey your interests? Was impartial? yes yes no no Was knowledgeable about the law relative to this case? Understood the issues in this case?

WHAT IMPACT DID MEDIATION HAVE ON THIS CASE? Settled the case Settled some of the issues DID YOU FEEL PRESSURED TO REACH AN AGREEMENT IN MEDIATION: DO YOU THINK MEDIATION IN THIS CASE SAVED YOU MONEY? Moved the case significantly toward settlement Clarified positions Added unnecessary steps Other: Increased tension

no

yes, by the mediator

yes, by the other side

yes, by time or money constraints

yes

no

DO YOU THINK MEDIATION IN THIS CASE SAVED TIME?

yes

no

WOULD YOU RECOMMEND MEDIATION TO A FRIEND?

yes

no

PLEASE USE THIS SPACE TO ADD ANY OTHER COMMENTS ABOUT YOUR EXPERIENCE IN MEDIATION:

PLEASE RETURN TO:

AOC - CIVIL PRACTICE DIVISION BOX 981 TRENTON, NJ 08625 FAX: 609 777-0844

Revised 6/21/2005, CN 10525-english

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