Confirm Mediation: Date: Time: 1Details2Payment This field is hidden when viewing the formPreferred NeutralThis field is hidden when viewing the formStatus*PendingAcceptedCanceledContactedCompleteThis field is hidden when viewing the formMediation Number*This field is hidden when viewing the formDate*This field is hidden when viewing the formTime*This field is hidden when viewing the formCase Type*This field is hidden when viewing the formHoursThis field is hidden when viewing the formPartiesThis field is hidden when viewing the formDemandThis field is hidden when viewing the formIssues Divorce Mod - Child Support Mod - Parenting Time Division of Property Domestic Violence This field is hidden when viewing the formIssuesThis field is hidden when viewing the formIs this a court-ordered mediation?This field is hidden when viewing the formCourtThis field is hidden when viewing the formCounty*This field is hidden when viewing the formState*This field is hidden when viewing the formCase NumberThis field is hidden when viewing the formContact*This field is hidden when viewing the formParalegal*This field is hidden when viewing the forms-client*This field is hidden when viewing the formScheduling Firm NameOpp Name*Firm Name*o-client*This field is hidden when viewing the formo-rep*Attorney Email* Phone*insurance*Opp Paralegalopp add Email This field is hidden when viewing the formdef side* Represents the Plaintiff Represents the Defendant This field is hidden when viewing the formplain side* Represents the Plaintiff Represents the Defendant Please Select a Payment Method - Credit Card or Invoice*Credit CardInvoiceThis field is hidden when viewing the formMethod2Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number EX Month010203040506070809101112 EX Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Terms* By attending mediation, I agree to ADR On-Demand's Agreement to Mediate Online. Untitled* All mediation fees are due if canceled within 24 hours of the mediation, and a partial fee will be assessed if rescheduled within 24 hours. Untitled* I understand the mediation will not exceed 3 hours. This field is hidden when viewing the formUntitled* I acknowledge that this mediation will be cancelled if payment is not received at least 48 hours before the scheduled mediation (notification will be sent only in the event of cancellation) This field is hidden when viewing the formcodeThis field is hidden when viewing the formdiscountCompanion Case Style3-Hour Virtual Mediation Fee Price: 3-Hour Virtual Mediation Fee Price: 3-Hour Virtual Mediation Fee Price: TotalTotal $0.00 This field is hidden when viewing the formentry Id*This field is hidden when viewing the formMediator*Please Selected a MediatorWayne C. WilsonJohn AustinAudrey BerlandMichael EshmanRusty GrantBianca Motley BroomJason HarperKristen PittsKay ThompsonTabitha PonderParag ShahLeesa BohlerShuli GreenBlane McCarthyJohn McCorveyGary NicholsonJim SheaAndy LaxElizabeth ToddCade ParianBryan SutliveLarry MimsMarci JoelCasey CrumbleyAndy RowlettAndy LaxDrew LewisRaymond AyresLuis VieraChristopher PennaThis field is hidden when viewing the formEmail* This field is hidden when viewing the formNotesYour Mediator has not uploaded notes for this matter. This field is hidden when viewing the formVideo Conference LinkThis field is hidden when viewing the formCase MetricsThis field is hidden when viewing the formNumber of Hours*This field is hidden when viewing the formSettled or Impasse*Settled or Impasse (Required)SettledImpasseThis field is hidden when viewing the formLast settlement offerThis field is hidden when viewing the formSettlement AmountThis field is hidden when viewing the formMedical BillsThis field is hidden when viewing the formLost WagesThis field is hidden when viewing the formProperty DamageThis field is hidden when viewing the formSpecial NotesCAPTCHACommentsThis field is for validation purposes and should be left unchanged. Please review and verify the above information about your mediation before you confirm your reservation.