• Referral Form

    Referral Form

  • Introduction

  • Family mediation is a process in which an independent, professionally trained mediator helps you work out arrangements for your children and/or finances following separation. ​Mediation can also be helpful when arrangements you've made before need to change, particularly as your children grow up. Mediation helps you stay in control. The mediator will help you to find a solution that works for you both and will explain what needs to happen to make an agreement between you legally binding. The process is less stressful and significantly quicker than going to court and can save you money. Legal aid is also available if you are financially eligible. 

    You can use this form to provide us with your contact details to begin the mediation process. Or you can contact us to request an alternative format.

    Once we have received a completed form, we can arrange a Mediation Information and Assessment Meeting (MIAM) for you.

  • Data Protection (GDPR)

  • Your Contact Details

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  • Other Parties Contact Details

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  • Issue(s) for Mediation

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  • Standard Questions

  • Funding

  • Our mediation service is amongst the most cost-effective options available. You can find details about our charges here: https://www.paxmediation.co.uk/mediation-fees

    If you proceed on a privately paying basis, we will send potential dates for an appointment upon receiving your referral.

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    We are also one of the few providers in the UK contracted to provide mediation funded by Legal Aid. If you are eligible, mediation is FREE for you. The Legal Aid assessment for Family Mediation is means-based, and you can find more information here: https://www.gov.uk/legal-aid

    If you proceed on a legally aided basis, we will send instructions on applying for legal aid upon receiving your referral. We will assess your eligibility ahead of your appointment and if you are not eligible you do not have to proceed.

  • Your Availability

  • Private Clients

  • Thank you for confirming that you will pay for the meeting. The next step is to arrange your Mediation Information and Assessment Meeting (MIAM).

    So that we can offer an appointment as soon as possible that suits your needs please indicate whether you would prefer an online (ZOOM), face-to-face or online out of hours appointment.

    Our charges are listed below:

    Online (Zoom) £130
    Face-to-Face / In person £150
    Out of Hours (Zoom) £200

    Please note, we currently have greater availability for Online (ZOOM) appointments and we may be able to offer an appointment sooner if you attend this way.

  • Conclusion

  • Now, please press submit to complete the referral form.

    • If you have told us that you will pay for your meeting, we will contact you by email shortly to provide potential dates.
    • If you have told us that you wish to apply for Legal Aid, we will re-direct you to the Legal Aid application form, and we will also send a copy of this to the email address that you provided. 

    Do check your junk and spam folders for our emails. If you are unable to correspond by email please contact us on 0800 058 4303.

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