Confidential Pre-­‐mediation Questionnaire

The completion and submission of your response to this questionnaire/guide is entirely voluntary, but it may give the mediator a better understanding of the concerns, interests and expectations of the participants. It is completely confidential and will be seen by the mediator only. Its other purpose is to help you organize your thoughts and to get you to think about the various implications of your dispute

Please provide a brief summary of the dispute.

This will help the mediator to understand the nature of the dispute.

Please address the following questions:
  1. What would it mean to you if you were able to settle your dispute in a manner acceptable to you?
  2. List your concerns, interests and/or expectations that need to be addressed by any settlement reached at the mediation: e.g. reputation, recognition, compensation, apology etc.
  3. Do you have any suggestions on how the other participant may address your concerns, interests and/or expectations in a settlement?
  4. List the concerns, interests and/or expectations, if any, which the other participant may wish you to address in a settlement?
  5. How, if at all, do you propose to address the concerns, interests and/or expectations of the other participant?
  6. Was their mutual trust between you and the other participant before you started to disagree?
  7. If there was mutual trust before, do you wish to restore the trust or is it more important to have a clean break with the other participant?
  8. What would an ideal solution of the disagreement you have with the other participant look like?

Have you applied your mind to the following potential consequences if the disagreement  between you and the other participant is not settled?

  1. How much litigation will cost, and how long it may take for litigation to be completed? Y/N
  2. The likelihood that even if you win the case, you may not be awarded costs from the other participant? Y/N
  3. The probability that even if you are awarded costs, these will not cover your actual costs? Y/N
  4. The personal and productive time taken up by preparation, consultation and attendances during litigation? Y/N
  5. The effect litigation may have on your relationship with the other participant? Y/N
  6. The effect of litigation on you, your or your family and/or organisation? Y/N
  7. The anxiety and stress caused by uncertainty over the judge or magistrate’s final decision? Y/N