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Florida Certified Circuit Civil Court Mediator, Attorney at Law   
 
Scheduling Form
Once all parties have agreed to a particular date/time, just complete this form and click to send it.

Please Note: A mediation is not officially scheduled on our calendars until we have contacted you to confirm.  We will make every effort to do so by 9:00 am the next business day.

REQUIRED INFORMATION

Preferred  Date/Time
Subject:
Subject
Enter the available date all parties have agreed to use:
First & Last Name ((mm/dd/yyyy)
Enter the preferred start time:
Organization (9:30 am or 1:30pm)
 
Location of Mediation
Please provide the name and physical address where the mediation will be held.  (Please review our Fees & Policies)
Phone  
   
Who Are You?
 
Email Your Name  
Email Organization or Firm
Email Work Phone/Ext.
Email Fax
Email Email
 
Case Site
Email Please indicate if Pre-Suit
Email
Email Case No:
     
This next section is to provide information about all parties to this matter.  There is space for 2 plaintiff parties and 3 defendant parties and an area to provide information if there are more parties involved.
Party Information
   
For the Plaintiff Party #1, please provide the following information:
Attorney or Representative
(Who will Appear at Mediation)
Email Work Phone/Ext.
Email Fax
Email Their Client's Name
   
For the Plaintiff Party #2, please provide the following information:
Attorney or Representative
(Who will Appear at Mediation)
Email Work Phone/Ext.
Email Fax
Email Their Client's Name
   
For the Defendant#1, please provide the following information:
Attorney or Representative
(Who will Appear at Mediation)
Email Work Phone/Ext.
Email Fax
Email Their Client's Name
   
For the Defendant#2, please provide the following information:
Attorney or Representative
(Who will Appear at Mediation)
Email Work Phone/Ext.
Email Fax
Email Their Client's Name
   
For the Defendant#3, please provide the following information:
Attorney or Representative
(Who will Appear at Mediation)
Email Work Phone/Ext.
Email Fax
Email Their Client's Name
   
 
Are there any other parties involved?   (Yes or No)
     
If yes, please provide all their contact information as you did above.
Email
   
CLICK SUBMIT REQUEST Button

We will confirm by email, a fax Confirmation and Engagement Letter. 

Please Fax us the Notice of Mediation or another pleading with the case style on it to:
(727) 368-5562

     

 

 

 


 
 

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