You will also need to submit one of the following payment options:
Mediation is a voluntary process and Mediation West is one provider of this service.
You or the other party may decline the invitation to mediate through our office and may work to resolve your issues through:
Code of Conduct Agreements
I am choosing to move forward with a voluntary case using Mediation West’s services and by doing so I acknowledge and agree to Mediation West’s Code of Conduct as stipulated in their Policy.
About Your Child(ren)
Your mediator will work with you to develop a Parenting Plan that considers the personality and developmental stage(s) of your children.
About MediationBy signing below, you consent to mediate with the other parent identified above according to the terms of the current Mediation West Policy. To read the full policy click here. Highlights of the policy include:
Recordings/transcriptions of sessions are not admissible in court and allowing other people to listen to sessions is strictly forbidden and may void any agreement reached.
Mediation West may share information about your mediation under certain circumstances (to read the full policy click here). If you would like us to release/receive information to/from someone, we need your authorization by checking the corresponding box below:
Typing and writing in the boxes below shall constitute an electronic signature and, along with processing my payment, constitutes valid evidence of my consent to mediate under the policies of Mediation West.
I, {name}, understand I am solely responsible for reviewing and understanding all the terms and conditions.
I, {name}, agree the electronically stored copy of this consent is enforceable to the same extent as if the documents and records were originally generated and maintained in printed form.
Mediation Costs
Fees for services are due and payable before sessions can be scheduled and refunds are limited (to read the full policy click here).
Mediation West has been approved for funding through government grants to help supplement the cost of mediation for those who qualify. We are excited to be able to offer this option to our clients. To use these funds, however, we must supply the grantor with verification of income that falls within the range they specify.
The verification of income documents they allow is any one of the following options:
You may choose one of the following options in the box below:
1. Submit a $39 non-refundable payment and proceed to the application for a reduced rate.
2. Submit a $159 initial installment and you will be contacted with your schedule for the 2 remaining installments of $160.
3. Submit a $479 payment for services through your first mediation session. If you agree to additional session(s) an additional payment will be required.
When submitting your request to mediate today, you will need to submit a $39 payment, complete the reduced fee application on the next page, and upload the required income verification. Once your application for reduced fees is processed, you will receive a link with the balance due and instructions for submitting your payment.
Please click one of the PayPal options to complete payment and submit the form.