SCHEDULE ARBITRATION OR MEDIATION

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Date Submitted (mmm/dd/yyyy)

Plaintiff Information

Defendant Information

Additional Parties

(if none, skip to case information)

Additional Parties

Service Requested

Is the case pending in a court?
Is the case court ordered?
Trial Date (mmm/dd/yyyy)
Enter Three Date Preferences and Any Comments.

If you have any questions about your mediation or arbitration, email us at: Robin@BergmanADRgroup.com, or call 713.977.1717.

We will be happy to help.