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ADR Forms for Parties

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Use these forms to ask the Court to defer/continue your case management conference
for 90 days and allow you and the other parties to resolve the dispute in mediation or arbitration.

 FORM NAME  FORM NUMBER
Stipulation to attend ADR for limited jurisdiction cases Local Court Form
(CV-659d)
Stipulation and Order to attend ADR for unlimited jurisdiction cases Local Court Form
(CV-655b)



Use the form below to inform the ADR Department and the Court of your choice of
mediator, arbitrator, or neutral case evaluator.

FORM NAME FORM NUMBER
Panel member selection form  (fillable online) Local Court Form
(ADR-201)



You may use one of the forms below to inform your panel member about your case.

FORM NAME FORM NUMBER
Mediation Statement Local Court Form
(ADR-304)
Arbitration Statement Local Court Form
(ADR-404)
Neutral Case Evaluator Statement Local Court Form
(ADR-504)



At the end of your ADR process, please fill out the appropriate civil case survey below.

FORM NAME FORM NUMBER
Mediation Survey (fillable online) Click here
Arbitration Survey (fillable online) Click here
Neutral Case Evaluator Survey (fillable online) Click here
Settlement Mentor Survey (fillable online) Click here



If you settle your case in ADR or by any other means use this form.

FORM NAME FORM NUMBER
Notice of Settlement of Entire Case Judicial Council Form
(CM-200)