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User Committee Feedback

Form for providing positive feedback and /or observations or concerns 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)


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 observations or concerns about a mediator or mediation, if any. 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.
Do you provide your permission for the mediator to be informed about this information? *
Yes
No

Details of your positive feedback, if any. If the mediation service has exceeded expectations we would also invite you to provide us with feedback so that we can pass this on to the person / team involved and learn from things we are doing right as well as from our mistakes. Also, if you would like to provide a testimonial stating that you are happy with the mediation service, the mediator will be pleased to receive this. Such a testimonial will not be used in a way that will breach the confidentiality of the mediation.
Letters, numbers, spaces & (*£$%&*_:;?.=!+-) only. 3000 chars max.

    

       




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