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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. Second 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 Summary field, above.)Family MediationHome Owners AssociationOther (Please explain in Summary field, above.)

7. Your Information

NonePoliceSheriffCity (Please indicate which city, below)

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