Fill and Sign the Presumptive Mediation Program Form

State of New Jersey ATTORNEY QUESTIONNAIRE Presumptive Mediation Program DIRECTIONS: This form is to be completed by attorn eys representing litigants in mediation at the conclusion of mediation. CASE DOCKET NUMBER C OUNTY DID YOU REPRESENT THE PLAINTIFF OR THE DEFENDANT IN THIS CASE? plaintiff defendant THE MEDIATOR FOR THIS CASE WAS SELECTED BY: parties/attorneys court/judge DO YOU THINK THE MEDIATOR IN THIS CASE: yes no gave you a full opportunity to convey your client's interests? Yes no was knowledgeable about the law relative to the case? yes no was impartial? Yes no understood the issues in this case? WHAT IMPACT DID MEDIATION HAVE ON THIS CASE? Settled the case Moved the case significantly toward settlement Added unnecessary steps Settled some of the issues Clarified positions Increased tension Other: AT WHAT STAGE IN THE CASE DI D THE MEDIATION SESSION TAKE PL ACE? (Check all that apply) before any discovery before depositions after experts’ reports served after interrogatories and document production after depositions after first trial date scheduled DO YOU THINK THIS CASE WAS REFERRED TO MEDIATION: DO YOU THINK MEDIATION IN THIS CASE SAVED MONEY? too early at about the right time too late yes no DO YOU THINK MEDIATION IN THIS CASE SAVED TIME? WOULD YOU CONSIDER MEDIATION FOR OTHER MATTERS? yes no yes no DO YOU THINK THAT MEDIATION: yes no generally preserves the legal rights of clients? yes no generally results in equitable outcomes? WHAT SUGGESTIONS DO YOU HAVE TO IMPROVE THE CIVIL MEDIATION PROGRAM? PLEASE PROVIDE ANY OTHER COMMENTS YOU THINK WOULD BE HELPFUL IN EVALUATING THE EFFECTIVENESS A ND QUALITY OF CIVIL MEDIATION. PLEASE RETURN TO: AOC - CIVIL PRACTICE DIVISION BOX 981 TRENTON, NJ 08625 FAX: 609 777-0844 Revised 03/03/2005, CN 10529-English page 1 of 1 For Office Use Only Date Received: Date Entered - AOC