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User Committee Feedback

Form for providing a serious complaint about a mediator or mediation


The matters you raise on this form will dealt with in accordance with the Feedback Policy on the website. (Red star denotes mandatory fields)



Declaration
I confirm either that my complaint to the Mediation Provider registered with the Civil Mediation Council of which the mediator is a member has reached the end of the process and not been resolved to my satisfaction or that I have asked the mediator to identify the mediation provider of which the mediator is a member but he or she has not done so. Complaints will not be dealt with until this confirmation has been provided.

*
I confirm

Your Full Name *
Letter / hypen / space / single quote only. 5->65 chars max.
Your Phone number *
Numbers, spaces, brackets & (+-) only. 10->32 chars max.
Your Email *
Valid email address. 254 chars max.
Mediator Name *
Letter / hypen / space / single quote only. 5->65 chars max.
Mediation Date *
DD MMM YYYY.
Details of your complaint about a mediator or mediation. * Letters, numbers, spaces & (*£$%&*_:;?.=!+-) only. 3000 chars max.
Why you think this is a serious complaint. * Letters, numbers, spaces & (*£$%&*_:;?.=!+-) only. 3000 chars max.
What you would like to happen. (That is, what you would like us to do with this information.) * Letters, numbers, spaces & (*£$%&*_:;?.=!+-) only. 3000 chars max.


               




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