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Start a Mediation

To request a mediation or make a referral, please complete this form.
For questions about whether a situation is appropriate for mediation, please call the Mediation hotline at 650.345.7272
If you would like to make a referral to mediation, please notify your referred parties first before completing. We will contact them directly within 5 days.
Additional mediation and process information is included here.
Please provide as much information as possible. If this is a referral, please complete for the people you are referring to mediation.

1. First Person's Information


2. Other Person's Information


3. List the names of any additional people involved:

4. Please provide a brief description of the issue and any information you think is important:

For Referrals ONLY

5. Why are you referring these individuals?

6. To which service are you making a referral?

Community MediationParent/Teen Mediation (Please indicate which party is the parent and which is the teen in the field, above.)Family MediationHome Owners AssociationOther (Please explain in field, above.)

7. If You Are A Recommending 3rd Party

NonePoliceSheriffCity (Please indicate which city, below)

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