Use these forms with your name as mediator.  Have the parties sign BEFORE you start your opening statement.  Each party gets a copy.

Opening Statement
Introduce yourself and credentials: Impartial and not an attorney.

Ask their names and preferred name for session

Discuss process - Confidential, No interruption ,etc

Logistics for bathrooms, breaks, caucus

Getting to an agreement and signing a binding memorandum of understanding (MOU).

Don't cut corners...do the whole process.

This page has the Confidentiality Agreement, NOTICE TO ALL PARTIES IN FAMILY CASES, and Agreement to Mediate.  Copies will be signed at the mediation.

Mediation Confidentiality Agreement  

The undersigned parties are attempting to resolve a dispute and have engaged the services of _______________________, as mediator.  In order to promote communication among the parties and mediator and to facilitate settlement of the dispute, we agree that the mediator has no liability for any act or omission in connection with mediation, and further agree:

All statements made during the course of the mediation are privileged settlement discussions, are made without prejudice to any party’s legal position, and are inadmissible for any purpose in any legal proceeding.  Any information disclosed to the mediator by a party, or by
a representative of a party, or by a witness on behalf of a party, is confidential.  The mediator cannot be compelled to disclose such information unless required to by law or court order.

All disclosures made during the course of this mediation are conditioned upon this promise and agreement of confidentiality. 

The mediator will act as a neutral mediator, will not act as an advocate for any party, and will not serve as legal counsel to any party.

We, __________________________and__________________________ will not seek, nor will we encourage or permit another, to compel the mediator to disclose any such confidential information in any legal or administrative proceeding or otherwise.  We may not introduce into evidence or use for any adversarial purpose any written or oral communication of the mediator.  We agree not to introduce into evidence or use for any adversarial purpose any other confidential information disclosed in this mediation, except as required by law or court order.

All privileges and the protection of attorney work product that pre-existed the mediation are unaffected by the mediation, whether or not disclosure is made in the mediation.

Breach of this agreement would cause irreparable injury and monetary damages would be an inadequate remedy, since we are relying upon this agreement of confidentiality in disclosing sensitive business and/or personal information.  We therefore agree and stipulate that any party to this agreement may obtain an injunction to prevent disclosure of any confidential information or mediator communication in violation of this agreement.  If any party breaches this agreement, that party shall be liable for and shall indemnify the other parties and the mediator for all costs, expenses, liabilities, and fees, including attorney’s fees,  that may be incurred as a result of such breach.

I have read the above statement, it was also read aloud to me, and I understand it.
 

Signed before mediation this_____ day of ______________, 2010.

 

Signature of Party (One)                                                                  Date                        

Signature of Party (Two)                                                                  Date                        

NOTICE TO ALL PARTIES IN FAMILY CASES

Mediation is an informal settlement conference. The sole purpose of this mediation is to attempt to resolve your case on a basis acceptable to you and the other parties to the case.  In the mediation process, you will be exploring the possibility of making agreements that will affect your legal rights concerning children and property.  You are advised to consult an attorney regarding these issues.  Agreements reached in mediation have legal consequences.   In this case, the mediation will be binding, and not subject to revocation. 

The mediator is neutral and cannot give legal advice.  ANY parties to the case may have a lawyer present at the mediation to assist them. 

You are encouraged to bring an attorney with you to the mediation, but it is not necessary.  Sometimes parties have their attorney on call, in the event that they have a legal question to be answered during the mediation. 

If you cannot bring an attorney with you to the mediation, you are encouraged to consult an attorney prior to and after the mediation.  The Houston Bar Association sponsors Houston Lawyer Referral Service, whose telephone number is 713.237.9429.  Through this service, you may obtain a 30-minute consultation for approximately $20.  You may also retain the attorney for additional services, such as reviewing the proposed agreement and/or the final order.

I have read the above statement, it was also read aloud to me, and I understand it.

Signature of Party (One)                                                                  Date                        

Signature of Party (Two)                                                                  Date                        

Use these forms for any civil mediation.  The Notice to Families is for only divorce cases.

Confidentiality and Agreement to Mediate are signed before the opening statement.

AGREEMENT TO MEDIATE

This is an agreement between ____________________________   and   ______________________________.

I understand that mediation is a process based on trust and cooperation that can help us discuss and resolve any conflicts that may exist between us.  I agree to work in a spirit of open and full disclosure and to provide complete and accurate information during the mediation, including facts, documents, financial data, etc., in order that all parties involved can reach informed decisions. 

I understand that the mediator is not a legal advisor and cannot provide legal advice to any party involved in mediation.  I understand that each party has the right too his or her own attorney, and I agree to notify all participants in the process if I have or obtain an attorney in this matter.  I understand that no subpoenas, citations, writs, or other process shall be served at or near the location of the mediation upon any person entering, leaving, or attending the mediation. 
 

I understand that mediation is confidential and that I can not call upon the mediator to testify concerning this mediation.  I agree not to subpoena any documents about the case.  I understand that the ____________________________(mediator's name) will not retain the Agreement to Mediate, Notice to all Parties in Family Cases, Confidentiality Statement, and Memorandum of Understanding related to this case for more than four years.   All other notes will be destroyed immediately following the mediation.    
 

I understand that if the mediator has cause to believe that a child’s physical or mental health or welfare has been or may be adversely affected by abuse or neglect by any person, the mediator is obligated by law to report it to the appropriate authorities and that those specific issues are not covered by the confidentiality of a mediation session. 
 

I understand that this mediation is binding, but may not be inclusive of all terms necessary to finalize the divorce, but serves only to bind the primary terms of understanding.    
 

I have read the above statement, it was also read aloud to me, and I understand it.