The Peer Mediation Referral Form can be filled out by a student referring him/her self or by faculty and staff who are referring students for peer mediation. Please fill out this form and submit to Ms. Montano or Ms. Endale.
peer_mediation_referral_form.pdf | |
File Size: | 143 kb |
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The Intake Form is to be filled out by the lead peer mediator and/or his/her co-facilitator prior to the scheduled mediation. Form should be filled out for each disputant separately.
intake_form.pdf | |
File Size: | 90 kb |
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The Mediation Consent Form is to be filled out at the start of the mediation.
mediation_consent_form.docx | |
File Size: | 38 kb |
File Type: | docx |
This Script is meant to serve as a guide for mediators and co-facilitators to follow during mediation.
script.pdf | |
File Size: | 322 kb |
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The Peer Mediation Agreement Form is to be filled out at the end of a mediation by the mediator/co-facilitator and signed by both disputants.
peer_mediation_agreement_form_for_disputents.pdf | |
File Size: | 79 kb |
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One Immediate Follow-up Survey is to be filled out by each disputant at the end of the mediation.
immediate_follow_up_survey_for_disputants.docx | |
File Size: | 18 kb |
File Type: | docx |
The Post Mediation Report is to be filled out by the mediator and co-facilitator at the end of each mediation.
post_mediation_report_for_mediators.pdf | |
File Size: | 273 kb |
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A One Week Follow-up Survey is to be filled out by each disputant one week after the mediation. Peer mediator and/or co-facilitator is responsible for presenting and collecting this survey to and from each disputant.
one_week_follow_up_for_disputants.pdf | |
File Size: | 96 kb |
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