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To Schedule a Mediation with Mark W. Sims -

1. Consult the on-line calendar at the link below regarding Mark W. Sims' availability for mediation. The calendar is updated each evening.

Mark W. Sims' Mediation Calendar

2. Coordinate with the parties and attorneys to determine a proposed mediation date that is workable for everyone and then send an e-mail to Mark W. Sims at texaslaw@austinmediation.com requesting the mediation date.

3. You will receive a confirmation from Mark W. Sims that the date is reserved as requested by the next business day. If, for any reason, the mediation cannot be scheduled as requested, you will be notified as quickly as possible but no later than the next business day.

4. Once you have received an e-mail from Mark W. Sims confirming the requested mediation date, complete and submit the form below:

Mediation Request Form -

Information Regarding the Parties

Petitioner

Salutation *

First Name *

Last Name *

Respondent

Salutation *

First Name *

Last Name *

Are there one or more Minor Children Involved in the Case? * YesNo

Attorney Requesting Mediation

Salutation *

First Name *

Last Name *

Address

Street Address

Address continued

City

State

Zip

Phone Number #:

*( )

* -

Fax Number #:

*( )

* -

E-mail Address *

The Attorney Requesting the Mediation Represents: * Petitioner
Respondent
Other

Other Party's Attorney

Salutation *

First Name *

Last Name *

Address

Street Address

Address continued

City

State

Zip

Phone Number #:

*( )

* -

Fax Number #:

*( )

* -

E-mail Address *

The Other Attorney Represents: * Petitioner
Respondent
Other

Is there any other person who should receive notice of the mediation? YesNo

Contact Information

Salutation

First Name

Last Name

Fax Number #

( )

E-mail Address

Is there any additional person who should receive notice of the mediation? YesNo

Contact Information

Salutation

First Name

Last Name

Fax Number #

( )

E-mail Address

Please submit additional party/contact information or any other information regarding the scheduling of the mediation in the comment section below.

This form is to submit a request for mediation on a specific date. The mediation is not confirmed until the parties have received written confirmation from Mark W. Sims, Attorney-Mediator, that the mediation has been scheduled on the requested date.

If the mediation cannot be scheduled with Mark W. Sims for whatever reason, you will be notified as quickly as possible but no later than the next day after submitting the form.

Once the mediation is scheduled, confirmations will be sent out to the parties via the contact information submitted with this form.

If you do not receive any communication from Mark W. Sims by the next business day after requesting a mediation date or completing this form, please contact Mark W. Sims at texaslaw@austinmediation.com.

By submitting this form, you agree to the cancellation policy (which applies to short notice cancellations) specifically outlined at Mr. Sims' website, www.austinmediation.com.

* I have read and agree with the statements above.

5. Once the Mediation Request Form is received, processed, and scheduled on Mark W. Sims' calendar, a confirmation notice will be forwarded to all parties via facsimile and e-mail (or by U.S. Mail) no later than the next business day.

6. To report any problems with this form, please send an e-mail to Mark W. Sims at texaslaw@austinmediation.com.

	Name of Child	Age
			MaleFemale
			MaleFemale
			MaleFemale
			MaleFemale
			MaleFemale
			MaleFemale
			MaleFemale