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1. How did you learn about the mediation program?
2. Did you have any prior knowledge of mediation?
yes
no
3. Had you ever taken part in mediation before?
Yes
No
4. Which statements apply: Strongly agree; Agree; Neither agree or
disagree; Disagree; Strongly disagree?
a. Either you or the other disputant saw a major principle at stake
b. Hostility existed between you and the other disputant
c. Either you or the other disputant were committed to a position
and had difficulty in moving from it
d. Either you or the other disputant were interested in settling
e. There were strong differences in views of the facts
f. Either you or the other disputant believed resolution would set
an important precedent
g. Were issues beside money involved
h. Was it in the financial interest of both to settle in mediation
i. Was reputation of you or the other disputant at stake
j. Was there lack of trust between you and the other disputant
5. Which of the following were important to your side? (Check up to
three)
Maintaining principle
Minimizing hostility between parties
Settling quickly
Setting a precedent
Minimizing expenses
Minimizing risk or exposure
Transforming your relationship with the other party
6. How did the outcome of the mediation compare to your experience
with the other usual ways to deal (or not deal) with conflict?
Satisfaction with the Mediation Process
7. Overall how satisfied were you with the mediation process?
8. Which best describes the effect of the mediation on your relationship
with the other party?
9. Was the information you received about the mediation program satisfactory?
Yes
No
10. Your view of the mediator:
Which statements apply: Strongly Agree; Agree; Neither agree or disagree;
Disagree; Strongly disagree?
The mediator did a good job explaining the process
The mediator possessed sufficient knowledge of the issues involved
The mediator listened well
The mediator treated me with respect
The outcome of the mediation was fair
The mediator allowed me to express my opinions freely
11. Would you use this mediation process again?
Yes
No
12. Would you use this mediator again?
Yes
No
13. Would you recommend this mediation program to someone else?
Yes
No
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