Alternate Dispute Resolution

Referral Form

Every relationship has its problems from time to time.

When those problems take a toll on our work, health, finances and our family, it is time to act. Conflict doesn’t have to be endured, it can be prevented, managed and resolved.

The staff at Conflict Resolution Service are passionate about tackling the heavy costs of conflict across the community. For 30 years, our network of professional practitioners has provided a confidential and effective service to the people of the ACT and surrounding region.

Do you know someone struggling with unresolved conflict that could benefit from professional mediation?

Refer them by completing our Referral Form below, and we’ll provide mediation services to help all parties reach practical and lasting solutions.

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Type of dispute
Referrer details
Details of dispute
Name
Email
Phone
Address
Housing Type
Language spoken at home
Do you require an interpreter?
Country of birth
Do you identify as Aboriginal or Torres Strait Islander? (You are welcome to specify cultural connections)
Do you identify as Aboriginal or Torres Strait Islander? (You are welcome to specify cultural connections)
Details of any disabilities
Date of Birth
DD slash MM slash YYYY
Gender
Paid Work
Occupation
Income Source
Income Bracket