Referrals

We accept referrals from clients direct or from other professionals, most usually solicitors.

We require a completed Mediation Form prior to starting the first session.

    Your Client

    Client Name *

    Address

    Date of Birth

    Email

    Home Tel

    Mobile

    Partner's Information

    Name

    Address

    Date of Birth

    Email

    Home Tel

    Mobile

    Children Information

    Name

    Age

    Name

    Age

    Name

    Age

    Name

    Age

    Your Firm's Information

    Name

    Address

    Email

    Telephone

    Ref Number

    What are the likely issues? ChildrenFinance and PropertyAll Issues

    Does your client's partner have a solicitor? YesNo

    Solicitor Information

    Name

    Address

    Email

    Telephone

    Ref Number

    Do you consider your client is eligible for public funding? YesNo
    Is this a referral for a Mediation Information and Assessment Meeting (MIAM)? YesNo

    We can offer legal aid in all of our outposts as we have a legal aid contract and all our mediators are accredited. If you think you might qualify for legal aid then please give us a call and we will let you know what evidence you need to produce.

    • £150 (inc VAT) for a Separate MIAM

    • £166.67 (inc VAT) per hour, per person for a mediation session

    Are you aware of any issues of domestic abuse which might affect the suitability of mediation? If you are, it is very important you give brief details below. YesNo