Mediation Satisfaction Questionnaire {CAO SC 4-9}

CAO SC 4-9 MEDIATION SATISFACTION QUESTIONNAIRE The purpose of this questionnaire is to obtain information to help us improve the quality of mediation services we provide. Your answers to the following questions would be very helpful to us. All answers are confidential. (To be filled out by the mediators) DATE: MEDIATOR (S): TYPE OF CASE: LENGTH OF MEDIATION SESSION: QUESTIONNAIRE INSTRUCTIONS This questionnaire includes yes/no questions and answer lines*. For each answer line question, you should place a mark on the line where you feel it best represents your opinion. You can mark anywhere on the line. For example, if you have a positive opinion about the question but believe there is room for improvement, you could answer the question as illustrated below. Negative/disagree Neutral Positive/agree Please answer every question and include your comments. Thank you for taking the time to complete this questionnaire. Please return your completed questionnaire to the court clerk before leaving. 1. A. Are you a Plaintiff or a Defendant ? B. What were your initial thoughts about mediation? Comments: 2. How would you rate your first impression of the mediators handling your case? Unfavorable Neutral Favorable 3. How would you rate the comfort and appropriateness of the physical setting arranged by the mediators for your session? Uncomfortable Neutral Comfortable 4. How clear were the introductory remarks and explanation of the mediation process offered by the mediators? Unclear Neutral Clear MEDIATION SATISFACTION QUESTIONNAIRE CAO SC 4-9 2/1/2010 PAGE 1 American LegalNet, Inc. www.FormsWorkFlow.com 5. How comfortable were you during the mediation session? Uncomfortable Neutral Comfortable 6. How would you rate your overall satisfaction with the manner in which the mediators conducted the mediation session? Dissatisfied Neutral Satisfied 7. How involved were you in the problem-solving process? Not Involved Neutral Involved 8. Did the mediators give both parties an equal chance to explain their case? Yes No Comments: 9. How fair were the mediators to both sides? Unfair Neutral Fair 10. If you had co-mediators assisting you, how well did the two mediators work together during the mediation process? Not Well Neutral Well 11. Did the mediation process address the main issues of your dispute? Yes No Comments: 12. Did the mediation end successfully (i.e., with a mutually agreeable solution)? Yes No Comments: 13. If you reached an agreement, were the terms and conditions of the agreement clear to you? Unclear Neutral Clear PAGE 2 American LegalNet, Inc. www.FormsWorkFlow.com MEDIATION SATISFACTION QUESTIONNAIRE CAO SC 4-9 2/1/2010 14. How well was the tone set for future problem solving with the other party? Negative Tone Neutral Positive Tone 15. Did you have enough time for the mediation? Yes No If no, how much more time was needed? Comments: 16. How satisfied were you with the overall mediation? Unsatisfied Neutral Satisfied 17. Are you willing to utilize mediation in the future? Yes No Comments: 18. Do you have any other comments or suggestions? *Answer line developed by Dr. Jack E. Vincent for U.N. research purposes. MEDIATION SATISFACTION QUESTIONNAIRE CAO SC 4-9 2/1/2010 PAGE 3 American LegalNet, Inc. www.FormsWorkFlow.com