PROBATE COURT PILOT MEDIATION PROGRAM

COURT REPORT and EVALUATION

County:	Date:

Type of Case: (Select One)

Guardianship	Conservatorship	Trust

Creditor Claim	Will Contest	Will Construction

Appointment/Removal of Personal Representative

Other (Please Specify)

Date Matter Filed:

Date Mediator Appointed:

Date Mediation Report Received:

For the following questions, please check the appropriate box.

Strongly Agree	Agree	No

Opinion	Disagree	Strongly Disagree
This process was helpful.
Mediation resulted in efficient use of the court's time.

The cost for mediation was reasonable considering the results obtained.

The outcome was acceptable.
Comments:

Number of Participant Reports Attached

Report Prepared by: Title:

FORM #316PC 08/2007

PROBATE MEDIATION PROGRAM

PROBATE COURT PILOT MEDIATION PROGRAM

Winkie Clark

2007-08-23

SCJD