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Refer A Case

Referring a case to ADR Group for mediation is very straightforward. Simply complete the online form below or download a PDF version and send to us by post or fax.

You can be assured that all cases are treated with the utmost confidentiality right from the start.

Having received your completed form, ADRg’s Case Management Team will endeavour to contact you as quickly as possible to discuss the next steps in the process and obtain all other relevant details.

 

Claimant:

Defendant:

First Name:

First Name:

Company Address:

Company Address:

Phone Number:

Phone Number:


Nature of claim and brief description:

Approximate amount of dispute:

Complexity (low / medium / high):


Claimant's Solicitor / Advisor:

Defendant's Solicitor / Advisor:

First Name:

First Name:

Firm:

Firm:

Address:

Address:

DX:

DX:

Phone Number:

Phone Number:

Fax Number:

Fax Number:

Email:

Email:

Ref:

Ref:

Have legal proceedings been issued?
If so, please provide copies of relevant pleadings (if appropriate) and indicate stage reached
 Yes:
No:
Is this a court referred mediation? Yes:
No:

Has mediation been discussed with the other party(ies)?

Yes:
No:

If yes, have all party(ies) agreed to mediation

Yes:
No:

If the mediation has not been proposed with the other party(ies), is ADR Group to approach them? Yes:
No:
Please indicate preferred timing for the mediation
 
Please indicate preferred location for the mediation
 

Are any of the parties legally aided? If so, please provide a copy of the legal aid certificate (as amended)

Yes:
No:

Is it usual for the mediation fee to be split equally between the parties. 

Yes:
No:

Is there an alternative arrangement in this case?

Yes:
No:

Would there be any objection to the appointment of a mediator local to the parties and their advisors

Yes:
No:

Will the parties professional advisor(s) if any be in attendance at the mediation along with the parties?

Yes:
No:

Do you consider it likely that any other person(s) will attend the mediation e.g. expert witnesses, friends, insurers representatives?

Yes:
No:

Do the partied have any objection to an observer being present during the mediation?

Yes:
No:

Are there any other issues you or your client consider important and which may be relevant to in the choice of mediator?

Yes:
No:

How did you hear about ADR Group?

 
 
 

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