Mediation Assessment form

Mediation Assessment Form

  • Assessors Name
  • Mediators Name
  • How did the mediator ‘meet & greet’?
  • Mediator’s opening statement (confidentiality, the process including separate sessions, mediator’s role, impartiality, guidelines, authority, questions, safety, and legal).
  • Feedback on Introduction
  • How did the mediator manage the opening statements from parties (concerns, interests and record statements).
  • Summaries: How did the Mediator go reading back statements using reported speech?
  • List of Issues: Did the Mediator use neutral language, mutualised issues and capture all topics?
  • Feedback on Opening Statements, Summaries and List of Issues
  • Exploration: How did the Mediator conduct each item and encourage parties to speak to each other and on each agenda item
  • Feedback on Exploration
  • Option Generation: Facilitated the stage (options were not generated by the mediator and negotiations did not commence).
  • Feedback on Option Generation
  • Private Sessions: Did the Mediator give equal time to both parties, identify BATNAS/WATNAs and reality test?
  • Feedback on Private Sessions
  • Negotiation: Did the Mediator allow both parties to contribute, facilitate the discussion of options, test options and note areas of agreement?
  • Feedback on Negotiation
  • Outcome Statement: Did the Mediator use the parties words, include action items, future disputes, balanced, ethical and clearly note any impasses?
  • Feedback on Outcome Statement
  • Closing Statement: Did the Mediator congratulate parties, clarify confidentiality and encourage parties to come back to mediation at any time?
  • Feedback on Closing Statement
  • Overall comments/suggestions for improvement
  • Overall Assessment

  • To what extent would you assess the level of competency of the mediator?