Mediation referral form for solicitors

Our mediation referral form is the most straightworward way for solicitors to refer clients to Family Mediation. Please fill in the mediation referral form below. Once completed, simply press send and a copy of the form will be emailed back to you for your records.

If you wish to refer a dispute to Civil and Commercial Mediation or to Workplace Mediation, it is better to call our main office on 0330 320 7600 and one of our mediators will call you directly to discuss further. Prefer to print and send? Download a PDF copy of our mediation referral form

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Your Client's Details


Your Details


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Details of Other Party


Other Party's Solicitor's Details, if represented

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Please indicate the following

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Submit referal form

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We will send a copy of the completed form to you via email for your records

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