WHY USE MEDIATION
HOW IT WORKS
ABOUT CRAIG
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Request Mediation
Request Mediation
Please fill in and submit the form below. Upon submission, I will contact you and the other party specified within 2 business days.
Initiating Party
Date of Request
Name
*
Phone Number
*
Email Address
Street Address
Apartment, suite, etc
City
State
ZIP / Postal Code
How would you like to be contacted?
*
Phone
Email
When would be a good day to call you?
When would be a good time to call you?
Hour
01
02
03
04
05
06
07
08
09
10
11
12
Minutes
00
15
30
45
AM
PM
Responding Party
Name
*
Phone Number
*
Street Address
Apartment, suite, etc
City
State
ZIP / Postal Code
Email Address
Is there a third party involved?
Yes
No
Name
*
Phone
*
Street Address
Apartment, suite, etc
City
State
ZIP / Postal Code
Email Address
Is there a fourth party involved?
Yes
No
Name
*
Phone
*
Street Address
Apartment, suite, etc
City
State
ZIP / Postal Code
Email Address
Does the underlying issue of dispute concern a landlord-property manager/tenant(s) lease agreement?
Yes
No
What are the specific issues in need of resolution? (Please check all that apply)
*
Non-Payment of Rent
Breach of Lease Conditions
End of Lease Term (Holdover Tenancy)
Habitability (Repairs/Maintenance Issues/Sanitary Conditions)
Pets
Number of Residents Exceeds Lease Agreement
Other
Please briefly describe the issue:
If non-payment of rent is an issue, would rental assistance from an outside agency or funds provider be considered to assist in arrearage payments?
*
Yes
No
Please describe the nature, history, background of the dispute/disagreement, and what efforts have already been attempted. The more specific the better.
*
Should circumstances require, do you have available internet access for a virtual meeting? (private setting, internet service, web camera)
Yes
No
Agreement and Signature
I understand that by submitting the Request for Mediation Services, I am authorizing Craig Ormsby, Mediator, to contact the other party(ies) to determine their willingness to participate in mediation and scheduling.
Requesting Party (Please type in your name as a digital signature)
*
Submit Your Request
If you have any questions about pursuing mediation,
Please Contact Me
