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Please choose the type of case and the time and date for your mediation
Case Type*
Time*
Time*
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Demand Offer*
Date*

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Do you have a preferred mediator?
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- I understand this is only a request; if my preferred mediator is unavailable, the mediation will be randomly assigned to another ADR On-Demand mediator.

Please provide the case and party details
Case Style*

Please do not use : / ? # [ ] @ ! $ & ' ( ) * + , ; = as characters in your case style.
County*
State*
Case Number
Court
Is this a court-ordered mediation?
*
- Yes
- No
Who do you represent?
Select a side*
- Represents the Plaintiff
- Represents the Defense
Scheduling Attorney
Scheduling Attorney*
Firm Name
Representing*
Insurance Carrier*
Email*
Enter Email Confirm Email
Additional CC
Enter Email Confirm Email
Scheduling Attorney's Phone*
Opposing Counsel
Defense Attorney*
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Representing*
- Represents the Plaintiff
- Represents the Defense
Insurance Carrier
Plaintiff's Attorney*
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Representing*
- Represents the Plaintiff
- Represents the Defense
Representing*
Email*
Enter Email Confirm Email
Additional CC
Enter Email Confirm Email
Opposition Attorney's Phone
Add Additional Party Information

Please include attorney name, email, and phone number for any additional parties.
Additional Party Info

Please provide payment information.
Payment Method*
Credit Card*

American Express
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Address*
Street Address Address Line 2 City State ZIP Code
Agreements*
- By attending mediation, I agree to ADR On-Demand's Agreement to Mediate Online.
Agreements*
- This fee is non-refundable if canceled within 48 hours of the scheduled mediation.
Agreements*
- I understand the mediation will not exceed 3 hours.
Agreements*
- 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)
Promo Code
Companion Case Information
Virtual Mediation*
Price:
Virtual Mediation*
Price:
Book One Get One Promo
ADRVIPLOYALTY (20% OFF)*
Price:
You earned $150 savings toward your Mediation > Thank you being a loyal client of ADR On-Demand!
Hanover Loyalty Discount*
Price:
20% OFF 5x (exp. 12/31/2022)
Friends of ADROD <> Stone Law Group*
Price:
20% OFF (-$150)
Companion Case
Price:
Companion Case
Rosner Super User (50% OFF)*
Price:
One Time 50% Off
ADR Super User (25% OFF) [Expired 9/15/22]*
Price:
Thank you for being an awesome client.
CCBA Small Solo Section Promo (-$250)*
Price:
$250 OFF
CCBA Small Solo Section Promo (-$250)*
Price:
$250 OFF
CCBA Small Solo Section Promo (-$250)*
Price:
$250 OFF
CCBA Small Solo Section Promo (-$250)*
Price:
$250 OFF
CAMBRE & ASSOCIATES Loyalth Discount (25% OFF) - Unlimited through 9/30/2022*
Price:
$750 (-$187.50)
BROOKS FIRM Welcome Discount (25% OFF) - Expired 8/31/2022*
Price:
$750 (-$187.50)
Virtual Mediation*
Price:
Multi-party Companion Case
Virtual Mediation*
Price:
Virtual Mediation*
Price:
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Who do you represent?

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