Can the Mediation Order Form be signed electronically?

Yes. Electronic signatures are generally valid under the ESIGN Act (15 U.S.C. §7001) and UETA where adopted, provided intent, consent, attribution, and record retention are satisfied. For consumer-facing matters, follow ESIGN disclosure requirements.

Who must sign the Mediation Order Form?

Typically parties or their counsel and the mediator sign. The order should identify who is authorized to bind each party and note any required settlement authority or representative presence.

Is a notary required to make the order enforceable?

Most mediation orders do not require notarization. Exceptions exist where local rules demand a notarized entry or when a signature must be notarized for another related document.

What if a party refuses to follow the order?

Noncompliance can be reported to the issuing court or mediator; remedies may include court sanctions or evidentiary consequences depending on the order's source and local rules.

How do you amend an issued Mediation Order Form?

Prepare a written amendment signed by the same parties and the mediator; if the original was filed, file the amendment with the court per local filing procedures.

Are mediation communications protected from later use in court?

Confidentiality depends on the order language and applicable evidence rules. Many jurisdictions protect mediation communications, but specific exceptions exist; include explicit confidentiality provisions in the order.

Electronic Signature
Templates
Legal
Mediation Order Form

Mediation Order Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Mediation Order Form

Court: Case No.:

Plaintiff / Claimant: Defendant / Respondent:

RECITALS

WHEREAS, the parties referenced above have filed or are subject to the above-captioned matter and have requested court assistance to facilitate a voluntary settlement through mediation; and

WHEREAS, the parties have proposed the appointment of a mediator or have requested that the Court appoint a qualified mediator to assist in resolving disputed issues; and

WHEREAS, the Court finds that mediation is appropriate to conserve resources, to facilitate settlement, and to further the interests of justice;

NOW, THEREFORE, IT IS ORDERED as follows:

1. Appointment of Mediator

The Court appoints as mediator in this matter. Mediator's affiliation or firm: . The mediator shall have the authority to conduct mediation sessions, to confer privately with the parties and counsel, and to make nonbinding procedural recommendations.

Mediator contact information: . Alternative contact or email:

2. Scope and Authority

The mediator shall mediate all claims and issues presently pleaded in this action and any related claims the parties agree in writing to include. The scope of mediation shall include liability, damages, and any contested equitable relief unless expressly excluded below.

Specific matters excluded from mediation (if any):

3. Scheduling and Deadlines

The parties shall confer with the mediator and submit to the Court a proposed mediation schedule within days of this Order. Mediation sessions shall commence no later than and shall be completed by unless extended by further order of the Court.

4. Attendance and Participation

Counsel and parties with full authority to negotiate and settle or with a representative possessing settlement authority shall attend in person or by remote means approved by the mediator. A party requesting representation by a corporate officer or insured representative must ensure that the person present has authority to engage in meaningful settlement negotiations.

If an insurer will participate, insurer contact for authority to settle:

5. Confidentiality and Privilege

All mediation communications, whether oral or written, made for the purpose of or in the course of the mediation are confidential and privileged to the fullest extent permitted by law. Such communications shall not be disclosed to the Court or used in any subsequent proceeding except: (a) to enforce a settlement agreement; (b) to seek relief from the Court for a breach of a mediation agreement; or (c) as otherwise required by law. The mediator shall not be compelled to testify or produce records relating to the mediation.

6. Settlement Discussions and Written Agreements

Any agreement reached in mediation shall be reduced to writing and signed by the parties. Such written agreement shall be binding and may be presented to the Court for approval, entry as an order, or enforcement. Offers, proposals, or concessions made during mediation shall not be admissible to prove liability or the amount of damages, except as necessary to enforce a signed settlement agreement.

7. Fees and Costs

The parties shall share the mediator's fees and any administrative costs in the manner set forth below. The mediator's hourly or session rate shall be per hour. Estimated retainer required: .

Allocation of mediator fees and costs (check applicable):

Parties shall share equally. Parties shall share in proportion to allocated percentage:

Payment terms: The retaining party shall pay the retainer within days of issuance of the mediator's invoice. Failure to timely pay may result in postponement or other relief.

8. Sanctions and Enforcement

If a party or counsel unreasonably fails to comply with this Order or fails to appear for scheduled mediation, the Court may impose sanctions, including monetary sanctions, continuance, or other remedies. The mediator may report material noncompliance to the Court when necessary to secure compliance or to enforce the mediation schedule.

9. Notices

All notices required or permitted under this Order shall be in writing and delivered to counsel or the party's designated representative at the addresses listed below.

Notice address for Plaintiff / Claimant: Notice address for Defendant / Respondent:

10. Amendment, Waiver, Counterparts

This Order may be amended or supplemented by written order of the Court. No waiver of any provision shall be effective unless in writing signed by the party against whom enforcement is sought. This Order may be executed in counterparts, each of which shall constitute an original, and facsimile or electronic signatures shall be effective for purposes of execution.

11. Governing Law; Entire Agreement; Severability

This Order shall be governed by the substantive and procedural law of the jurisdiction of the issuing Court. This Order constitutes the entire mediation order between the parties and supersedes prior related orders to the extent inconsistent. If any provision of this Order is found unenforceable, the remaining provisions shall remain in full force and effect.

12. Special Instructions

Additional instructions to mediator or Court (if any):

Parties shall, within days after the conclusion of mediation, file a joint report notifying the Court whether the matter was resolved or remains pending and indicating any agreed deadlines.

Plaintiff / Claimant:

By:

Date:

Defendant / Respondent:

By:

Date:

What the Mediation Order Form Is and what it does

A Mediation Order Form is a written directive used to set the procedural framework for a mediated dispute, documenting the mediator assignment, participant identities, confidentiality rules, scheduling, pre‑mediation disclosures, and logistical requirements. It clarifies who must attend, what materials must be exchanged, deadlines for submissions, and any interim measures the mediator or court orders. The form may be issued by a court, jointly prepared by counsel, or supplied by a mediator. Where permitted, parties may execute the form electronically under ESIGN and applicable state UETA or ESRA rules.

Why a clear Mediation Order Form matters

Using a Mediation Order Form reduces uncertainty by fixing dates, exchange obligations, confidentiality terms, and mediator authority in writing. It minimizes procedural disputes, documents agreed processes for later enforcement, and helps parties and counsel prepare efficiently for settlement discussions or follow‑up court filings.

Who typically prepares and completes the Mediation Order Form

The Mediation Order Form is completed by counsel, the assigned mediator, or the court to establish the mediation process and responsibilities.

Plaintiffs or claimants' counsel coordinating session logistics, disclosures, and exhibit exchanges.
Defendants or their counsel confirming attendance, settlement authority, and pre-mediation submissions.
Court clerks or mediators issuing orders, assigning mediators, and specifying confidentiality terms.

Accurate completion assigns tasks clearly, reduces scheduling conflicts, and serves as a reference if disputes arise about compliance with the mediation protocol.

Core elements included in a professional Mediation Order Form

A complete Mediation Order Form captures parties, mediator details, confidentiality and privilege rules, exchange timelines, logistics, and the execution block so the order is actionable and reproducible.

Parties

Full party names, counsel and contact details so notices and materials are delivered to the right representatives and service is documented.

Mediator

Mediator name, organization, contact information, fee allocation, and any authority to impose or recommend interim measures during the mediation.

Confidentiality

Explicit confidentiality and privilege provisions describing what is protected, who may receive communications, and whether evidence is admissible in later proceedings.

Exchange Schedule

Dates and formats for exchanging position statements, exhibits, witness lists, and any expert reports prior to the mediation session.

Logistics

Session date, start/end times, physical or virtual location details, remote access instructions, and expectations for attendance.

Execution

Signature blocks for parties and mediator, date signed, and notation of electronic execution method if the form is e-signed.

Step-by-step: completing and issuing the Mediation Order Form

Follow these sequential steps to prepare, circulate, and finalize the mediation order.

01

Prepare Draft: Draft order with parties, mediator, confidentiality, and deadlines.
02

Circulate to Parties: Send draft to counsel for review and edits.
03

Agree and Sign: Obtain signatures from parties and mediator, e-signed if permitted.
04

File/Record: File with the court or deliver to clerk if required by local rules.

Typical routing and handling for the Mediation Order Form

A standard routing sequence ensures documents reach all participants and the court when required.

Upload: Upload the drafted order to the case file or mediation platform.
Assign Mediator: Confirm mediator assignment and fees before finalizing the order.
Distribute: Share the signed order with all counsel and the mediator.
Record: File with the court clerk when the local rule mandates or parties request entry.

Typical online workflow settings when completing the form electronically

Map the form fields to platform settings to automate routing and authentication.

Field	Configuration
Signature Field	Required; signer routing order
Date Field	Auto-fill on completion
Attachment Field	Accepts PDFs up to 10 MB
Authentication	Email + optional SMS code

Digital signing and file format considerations

Ensure the chosen platform supports required file formats and authentication before e-signing the order.

Formats: PDF, DOCX supported
Integrations: Works with Salesforce, NetSuite, Google Workspace
Security: TLS in transit; AES-256 at rest

Common deadlines to include or monitor

Spell out clear due dates in the order to avoid disputes and preserve the mediation schedule.

Session Date:

Date and time of the mediation session.

Exchange of Materials:

Example: 7–14 days before the session for disclosures.

Addendum Deadline:

Deadline to submit late exhibits or stipulations.

Filing with Court:

If required, file within time specified by local rule.

Settlement Notification:

Time for advising the court if settlement is reached.

Key milestones from order issuance to mediation session

Track these numbered stages to ensure the order's timeline is met and the session proceeds as planned.

01

Order Issued

Draft finalized and distributed to all parties.

02

Document Exchange

Parties exchange position statements and exhibits by the set deadline.

03

Pre‑Mediation Conference

Optional call to address logistics and narrow issues.

04

Mediation Session

In-person or virtual session conducted per order.

Common mistakes to avoid when preparing the Mediation Order Form

Leaving session time zones unspecified, causing scheduling conflicts for remote participants.
Failing to name the mediator or include contact details, delaying confirmations and fee arrangements.
Using vague exchange instructions such as 'reasonable time' instead of exact dates and formats.
Omitting execution blocks or e-signature consent language where electronic signing will be used.

Essential information fields that must appear on the form

Party Names: Full legal names

Case Number: Court docket number

Mediator: Name and contact

Confidentiality: Scope and limits

Session Date: MM/DD/YYYY format

Signatures: All parties and mediator

Consequences of errors or omissions on the Mediation Order Form

Scheduling Delays: Lost time

Service Failures: Misdelivered notices

Enforceability Risk: Agreement disputes

Sanctions: Court may impose fees

Confidentiality Breach: Loss of privilege

Invalid Signatures: Non-binding execution

How a Mediation Order Form differs from other court documents

Compare the mediation order to similar orders so users understand scope, enforceability, and intended use.

Document Type	Court Order	Mediation Order
Authority	judicial	mediator-facilitated
Timing	throughout case	pre- or mid-case
Confidentiality	public unless sealed	often confidential
Typical Use	adjudication	settlement facilitation

eSignature vendor comparison for signing and distributing the Mediation Order Form

Compare starting prices and key capabilities across common eSignature vendors. signNow is listed first per table convention.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes (Business Premium)	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Real-world examples of Mediation Order Form use

Two concise examples show how the form resolves logistics and records mediation terms.

Court-Directed Mediation

A federal magistrate issued a mediation order to set timelines and mediator fees

Parties exchanged position statements 14 days before session
The order reduced discovery disputes and provided a clear record for the eventual settlement filing and closure.

Private Mediator Session

Counsel jointly drafted an order to allocate mediator fees and confidentiality terms

The mediator required a signed order before scheduling
The signed form prevented later disagreement about exchange obligations and preserved privilege.

Frequently asked questions about Mediation Order Forms

Answers to common questions about execution, enforceability, e-signing, notarization, amendments, and what to do if a party refuses to comply.

Need help? Contact support

Can the Mediation Order Form be signed electronically?
Yes. Electronic signatures are generally valid under the ESIGN Act (15 U.S.C. §7001) and UETA where adopted, provided intent, consent, attribution, and record retention are satisfied. For consumer-facing matters, follow ESIGN disclosure requirements.
Who must sign the Mediation Order Form?
Typically parties or their counsel and the mediator sign. The order should identify who is authorized to bind each party and note any required settlement authority or representative presence.
Is a notary required to make the order enforceable?
Most mediation orders do not require notarization. Exceptions exist where local rules demand a notarized entry or when a signature must be notarized for another related document.
What if a party refuses to follow the order?
Noncompliance can be reported to the issuing court or mediator; remedies may include court sanctions or evidentiary consequences depending on the order's source and local rules.
How do you amend an issued Mediation Order Form?
Prepare a written amendment signed by the same parties and the mediator; if the original was filed, file the amendment with the court per local filing procedures.
Are mediation communications protected from later use in court?
Confidentiality depends on the order language and applicable evidence rules. Many jurisdictions protect mediation communications, but specific exceptions exist; include explicit confidentiality provisions in the order.

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now