Your experience during mediation is important to the New Hampshire Judicial Branch. Please provide us with feedback regarding your experience by filling out this questionnaire. Thank you for your comments.

If you wish to comment further on your mediation experience, please contact the Office of Mediation and Arbitration at mediation@courts.state.nh.us

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* 1. Who was your mediator?

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* 2. What was the date of mediation?

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Date

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* 3. What is the name of your case? (example: Smith v. Jones)

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* 4. What is the case number?

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* 5. What type of case was it?

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* 6. Mediation had the following impact on this case:

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* 7. The mediator explained the mediation process clearly and answered all of my questions.

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* 8. I was treated fairly and with respect throughout the mediation process.

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* 9. The mediator was impartial and treated all parties equally.

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* 10. The mediator helped us to explore different options to resolve the dispute.

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* 11. The mediator was prepared for mediation and knowledgeable about the issues involved.

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* 12. I would use mediation again if needed in this case (or another case).

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* 13. I would use this mediator again or recommend him or her to others.

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