PLEASE ONLY FILL OUT YOUR INFORMATION (NOT THE OTHER PARTY'S INFORMATION)

If you have questions about how to properly fill out this form please contact our office at 580-581-5420

If you are NOT the initiating party in this matter please skip to the RESPONDENT portion of this form. 

If you are NOT the responding party in this matter please scroll back up to the INITIATING portion of this form.

We agree to participate in the mediation process in an effort to resolve our dispute. "Mediation" means the process of resolving a dispute with the assistance of a mediator outside of a formal court proceeding. Our rights and obligations under the Dispute Resolution Act, 12 O.S. 2011, sections 1801 et seq., and the Rules and Procedures for the Dispute Resolution Act include:

1. We shall meet with a mediator in an informal, confidential setting. 2. The mediator will assist us in discussing and clarifying the issues. 3. We shall cooperate with each other and the mediator in working toward a mutually acceptable agreement to end our dispute. 4. The mediator will not offer legal advice or make any decisions for us.

5. When an agreement is written and signed to end our dispute, all parties will receivea copy. Parties to a family and divorce matter will receive an unsigned Memorandum of Understanding to be submitted to an attorney and/or judge for review. 6. We shall be responsible for protecting our own rights and property through any pending legal proceedings. Oklahoma law provides that mediation is a confidential, private process and that information obtained from a mediation may not be disclosed unless otherwise required by law. For example, a mediator must disclose information brought to his/her attention that an elderly person, or a person with disabilities or a child under the age of eighteen (18) has been abused or neglected. We recognize that if a minor is party to the mediation, the agreement may not be enforceable. We hereby release from liability the sponsoring agency for any claimed damages arising out of any action, statement, or decision made or taken in the mediation session, except where provided in the Dispute Resolution Act. We acknowledge that we have read and understand this agreement, and we hereby agree to abide by its terms.

PLEASE NOTE:

The signature blocks are very sensitive.  Please ensure that your entire signature is within the signature block before hitting submit.  Forms with incomplete signatures will be returned for completion

 

RULE 10 FORM

Alternative Dispute Resolution System Confidentiality of Proceedings and Rules of Conduct for Parties attending Mediation Hearing

As ordered by the Oklahoma Supreme Court, all persons attending a proceeding in the Dispute Mediation Program must abide by the following Confidentiality Provisions and Rules of Conduct, and must execute this Acknowledgement Form before attending a mediation proceeding.

CONFIDENTIALITY OF PROCEEDINGS - 12 O.S. §1805

Any information received by a mediator or a person employed to assist a mediator, through files, reports, interviews, memoranda, case summaries, or notes and work products of the mediator, is privileged and confidential. No part of the proceedings shall be considered a matter of public record. No mediator, initiating party, or responding party in a mediation proceeding shall be subject to administrative or judicial process requiring disclosure of any matters discussed or shall disclose any information obtained during any part of the mediation proceeding. Each mediation session shall be informal. No adjudication sanction or penalty may be made or imposed by the mediator or the program. No mediator, employee, or agent of a mediator shall be held liable for civil damages for any statement or decision made in the process of mediating or settling a dispute unless the action of such person was a result of gross negligence with malicious purpose or in a manner exhibiting willful disregard of the rights, safety, or property or any party to the mediation. Ifa party who has participated in mediation brings an action for damages against a mediator arising out of mediation, for purposes of that action the privilege provided for in subsection A of this section shall be deemed to be waived as to the party bringing the action.

A. All persons attending a mediation session shall respect and maintain the total confidentiality of the session. 

B.When one party in a mediation session requests an assisting party, the following rules must be outlined and agreed to by the assisting party prior to initiating the mediation session: 

1. An assisting party may advise only his/her client. The assisting party shall speak only with the mediator or his/her client and cannot interrogate the opposing party during the mediation session. 

2. The party without an assisting person present must consent to allowing the other person's assisting party in the mediation session, or be given the opportunity to secure his/her own assisting party to be present during the mediation session.

3. If a party who is without an assisting party refuses to participate in mediation due to the presence of another's assisting party, no mediation session will be conducted.

C. If a party requests a non-assisting friend or relative to attend the session, attendance shall be allowed only if agreed upon in advance by the other party and is not in violation with program policy. The person may then be in the room but in no way may interrupt, or interfere with proceedings. Such a person shall not be heard nor allowed to display distracting behavior.

D. If the mediating parties agree, a neutral third party may serve as a resource person for the mediator and the parties. Such a person shall participate only on request and must remain impartial.

E.Mediation sessions shall not be filmed, taped, or otherwise recorded.

F. All notes or other writings produced by the mediator or any other person while a mediation is in session shall be collected by the mediator at the end of each session and held in a confidential file until the mediation process is completed. When the mediation process is completed, whether or not an agreement is reached, all notes and other writings produced while a mediation is in session, except the written agreement or memorandum of understanding, shall be destroyed.

ACKNOWLEDGEMENT: By signing below, I acknowledge that I have read and understand the above Confidentiality Provisions and Rules of Conduct for Outside Parties Attending Mediation Hearing, and agree to abide by these rules for this mediation proceeding.

PLEASE NOTE:

The signature blocks are very sensitive.  Please ensure that your entire signature is within the signature block before hitting submit.  Forms with incomplete signatures will be returned for completion. 

Now that you've completed this form please call 580-581-5420 to do your required pre-mediation interview.