Please wait until after you have received a Notice of Mediation from USA&M to submit this form. If you would like to submit your case for mediation with any of our mediators, please use the Mediation Case Submission Form.

Please complete and submit Mediation Case Information Form below. Our office will reply with confirmation when the form is received.

Mediation Case Information Form

Mediation Case Information Form
(ie Personal Injury, Medical Malpractice, etc.)