Mediation Services: Feedback Form

1. Communications during the intake process was:
   Good Poor See below

2. Were questions answered satisfactorily?
   Yes No See below

3. Was the mediation scheduled to meet your needs?
   Yes No See below

Comments regarding the intake process:

1. The mediation session was:
   Acceptable Too long Too short

2. Were the mediators fair, impartial and professional with all parties?
   Yes No See below

3. Did the mediators make you feel comfortable discussing your situation?
   Yes No See below

4. Did the mediators help everyone understand the important issues of the situation?
   Yes No See below

5. Were you satisfied with the terms of your written settlement agreement?
   Yes No See below

Comments about the Medation Session:

Post-Mediation Satisfaction:

1. Has the mediation caused the relationship to be:
   Improved Remain the same Worsened

2. Have you referred to the settlement agreement:
   Often Occasionally Never

Comments about Post-Mediation:

General Feedback:

1. How did you originally become aware of NOAA's Alternative Dispute Resolution Program?
   

2. Would you recommend this program to others:
   Yes No

Because:

Other comments:

Personal information (optional)

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