314-231-4642
800-844-4237

500 N. Broadway, Suite 1800 Saint Louis, MO 63102

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Mediation
Arbitration
CLE
- Seminars
- Past Seminars
  - Title IX Training
Scheduling
Testimonials
News
Contact/Parking

Mediation Case Submission

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Mediation Case Submission

To submit a case for mediation, please complete and submit our Mediation Case Submission Form below or contact us.

All fields for Parties 1 & 2 are required.

Fields for Parties 3 through 7 are only required if more than 2 parties are participating in the mediation. If an attorney is representing more than one party, those parties may be listed in one field.

After receiving the case submission form, someone from USA&M will confirm.

USA&M provides the mediator and the venue and obtains the parties’ agreement to mediate. For mediations there is no filing fee and no charge if we are unable to get the necessary parties agreement to participate.

We structure our process to facilitate closing files, not to increase your workload. You do not have to get the other side to agree before sending us the case.

Feel free to contact us with any questions you may have.

Mediation Case Submission Form

Mediation Case Submission

Form Prepared By: *

Your Email Address:

Has a mediator been selected?

Yes

If yes, please name:

Have any mediation dates been identified?

Yes

If yes, please list date(s):

If no, please specify a date range (ie the next 30 days):

Is this via ZOOM, In Person or Hybrid?

ZOOM

In person

Hybrid (In person & ZOOM)

Will any of the attendees be participating remotely and need a Zoom link?

Yes

If someone will need a Zoom link, please list name(s) and if they are with Plaintiff or Defendant:

Is this case a new mediation with USA&M or is this being rescheduled?

New mediation

Rescheduled mediation

If it is being rescheduled, please provide the USA&M case number or the title of the case and you do not need to provide all the information below.

Is this a Small Claims (Flat Fee) Mediation?

Yes

PLEASE NOTE: NOT ALL MEDIATORS DO FLAT FEE MEDIATIONS. To qualify for the Flat Fee program, it must be a 2-party case with the last monetary demand being $75,000 or less. More information regarding the Flat Fee program (including the list of mediators that participate in this program) can be found at www.usam.com/mediation/flat-fee-mediation-program

Party #1 Full Name(s):

Party #1 Role:

Counsel Full Name, Address, City, State, Zipcode, Telephone and Fax:

Counsel's Email Address

Party #2 Full Name(s):

Party #2 Role:

Counsel Full Name, Address, City, State, Zipcode, Telephone and Fax:

Counsel Email Address

Case Type:

If Other, list:

Is this case in suit?

Yes

Is this case court ordered?

Yes

List Venue

Cause #:

Last offer:

Last demand:

Who made last offer/demand?

List specials

The costs of mediation are to be paid:

Please include any additional information for the case administrator here:

Party #3 Full Name(s):

Party #3 Role:

Counsel Full Name, Address, City, State, Zipcode, Telephone and Fax:

Counsel Email Address:

Party #4 Full Name(s):

Party #4 Role:

Counsel Full Name, Address, City, State, Zipcode, Telephone and Fax:

Counsel Email Address:

Party #5 Full Name(s):

Party #5 Role:

Counsel Full Name, Address, City, State, Zipcode, Telephone and Fax:

Counsel Email Address:

Party #6 Full Name(s):

Party #6 Role:

Counsel Full Name, Address, City, State, Zipcode, Telephone and Fax:

Counsel Email Address:

Party #7 Full Name(s):

Party #7 Role:

Counsel Full Name, Address, City, State, Zipcode, Telephone and Fax:

Counsel Email Address:

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United States Arbitration & Mediation (USA&M)

Phone: 314-231-4642, 800-844-4ADR (4237) Fax: 314-231-0137 Address: 500 N. Broadway, Suite 1800, Saint Louis, Missouri 63102 Email

NOTE: Nothing contained herein is intended to give legal advice. Individuals should always consult with an attorney before entering into a contract.

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