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.
I am choosing to move forward with a voluntary mediation 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 Mediation
By signing below, you consent to a facilitated conversation with the Mediation West mediator and any other professionals/support persons appropriate for your case, according to the current Mediation West Policy. Highlights of the policy include:
Mediation West may share information about your case under certain circumstances. If you would like us to release/receive information to/from someone, we need your authorization by completing below:
As a Nebraska ODR-approved mediation center, Mediation West is subject to reporting requirements which includes the following statistical information. Your answers to these questions will assist us in completing these reports.
Funding for the small claims program comes from grant funds that require the following information.
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 funding through a government grant 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:
When submitting your case 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.
When submitting your case today, you will need to submit your initial installment of $159 payment. You will be contaced with your schedule for the 2 remaining installments of $160.
You are {areYou} and have responded "{doYou144} want to participate".
You are {areYou} and selected to pay ${pleaseChoose} today.
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 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.
Please click one of the PayPal options to complete payment and submit the form.