Form Nhjb-2324-F - Mediation Report
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THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
Court Name:
Case Name:
Case Number:
(if known)
MEDIATION REPORT
1. Name of Mediator:
2. Date of Scheduled Mediation Session:
3. Periodic Mediation Report:
Mediation has been rescheduled to (date/time)
at the request of:
Petitioner
Respondent
Mediator
Reason for rescheduling:
Parties have agreed to ongoing mediation. The next session date/time is:
Parties have agreed to ongoing mediation, with the next session date/time of:
However they ask the court to schedule the next event at this time.
4. Final Mediation Report:
Mediation session ended due to disagreement over attorney or third party participation.
Case settled prior to mediation session.
Case may be appropriate for mediation but not with this mediator due to a conflict of interest or
incompatibility between mediator’s strengths/style and parties’ needs.
Case tentatively settled during mediation session. Parties were encouraged to seek legal review. A
written agreement, covering all essential issues signed by the parties:
is attached
will be submitted to the court within 30 days
will be submitted within 45 days
upon review/input of parties’ counsel.
Case settled in part. Parties were encouraged to seek legal review. A written partial agreement,
covering essential issues and signed by the parties:
is attached
OR
will be submitted to the court within 30 days.
The following issues were not resolved:
The parties request
a Temporary Hearing, as sought in the initial pleadings, on the remaining issues
or
a Scheduling Conference prior to a Final Hearing.
Case did not settle; court to schedule next hearing.
The following parties failed to appear:
Other:
I certify that on this date I provided a copy of this document to
) or to
(the parties
) by:
Hand-delivery OR
US Mail OR
(the parties’ attorney
.
E-mail
(E-mail only by prior agreement of the parties based on Circuit Court Administrative Order)
Date
Mediator
THIS FORM MUST BE FILED WITH THE COURT WITHIN 3 DAYS OF THE MEDIATION SESSION.
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NHJB-2324-F (08/20/2014)
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