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Statewide Civil, General Equity and Probate Mediation Program

Litigant Questionnaire

Directions: To be completed by the litigant at the conclusion of mediation.

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* 1. Case Docket Number (e.g. L-000067-10)

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* 2. Name of Mediator

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* 3. County

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* 4. The mediator for this case was selected by?

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