It is easy to make a referral to Midlands Mediation.
Step 1 – Select the correct referral form by clicking on the relevant link below
Step 2 – Complete the form and save a copy for your own records
Step 3 – Attach and send it to us using the facility below
Step 4 – Let us do the rest!
REFER YOURSELF. If you wish to refer yourself to mediation or for an assessment, please download this form: Family Mediation SELF Referral Form 2011
REFER YOUR CLIENT. If you wish to refer your client to us for mediation assessment, please download this form: INITIAL MEDIATION REFERRAL FORM(2011)
Please download the Civil Referral form here: CIVIL MEDIATION REFERRAL FORM (2011)
Please download the Workplace Referral form here: WORKPLACE MEDIATION REFERRAL FORM (2011)
We will confirm receipt and contact the parties involved to make appropriate arrangements.
Complete it, and send it back to us below: