Because people see things differently

Mediation Evaluation Form

This information will be used to inform the court system and the mediator about your experience with mediation.  With your help, we can ensure that quality mediation services continue to be available to the citizens of the Commonwealth.  This information will be shared with the mediators.

What is your role in this case?*
For this case the mediation was (select one):*
The mediation process was:*
Mediation ended with an agreement on:*
Would you use mediation again?*
Would you recommend mediation to others?*
The mediator explained the mediation process and procedures*
Please rate your mediator on the following by indicating your rating (5 = very good, 4 = good, 3 = adequate, 2 = unsatisfactory, 1 = poor, 0 = does not apply)
The mediation provided useful informaiton*
Please rate your mediator on the following by indicating your rating (5 = very good, 4 = good, 3 = adequate, 2 = unsatisfactory, 1 = poor, 0 = does not apply)
The mediation was a good listener*
Please rate your mediator on the following by indicating your rating (5 = very good, 4 = good, 3 = adequate, 2 = unsatisfactory, 1 = poor, 0 = does not apply)
The mediator allowed me to talk about issues that were important to me:*
Please rate your mediator on the following by indicating your rating (5 = very good, 4 = good, 3 = adequate, 2 = unsatisfactory, 1 = poor, 0 = does not apply)
The mediator was respectful*
Please rate your mediator on the following by indicating your rating (5 = very good, 4 = good, 3 = adequate, 2 = unsatisfactory, 1 = poor, 0 = does not apply)
The mediator helped clarify issues:*
Please rate your mediator on the following by indicating your rating (5 = very good, 4 = good, 3 = adequate, 2 = unsatisfactory, 1 = poor, 0 = does not apply)
The mediator encouraged us to come up with our own solutions:*
Please rate your mediator on the following by indicating your rating (5 = very good, 4 = good, 3 = adequate, 2 = unsatisfactory, 1 = poor, 0 = does not apply)
Did the mediator inform you that you could consult an attorney?*
Was the mediator neutral (didn't take sides)?*
Did the mediator write you agreement clearly and accurately?*
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Thanks. If you haven't already completed the Demographic Survey form please do so by visiting: https://smartsolutionsva.net/mediation-forms Thank you!

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