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STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 17th JUDICIAL CIRCUIT COUNTY OF BOONE WINNEBAGO
FILE STAMP PETITIONER/PLAINTIFF, v. Case No. RESPONDENT/DEFENDANT.
MEDIATOR REPORT
☐I mediated with ___, and ___.
☐ I scheduled meetings on _____.
□I met with them on _____ for a total time of _____. (00.00)
□Prior to and during mediation, I screened the case for eligibility pursuant to Local Rule 14.08 Rule 6 on safety protocols, and determined that the matter □ was □ was not eligible.
□No mediation occurred because a prior agreement resolving all issues was reached.
□No mediation occurred because _____ failed to: □ contact the mediator to schedule mediation □ appear for a scheduled mediation □ pay the mediator.
□One or both the parties has/have not completed the parent education program as required by Local Rule 14.08(2)(B).
□ No mediation occurred because one or both parties has indicated a change in financial circumstances since ordered to mediation, and the case is being sent to court for clarification
- A. The mediation has now concluded because:
☐The parties have reached an agreement as to all disputed issues.
□The parties have reached an agreement as to some of the issues and are at an impasse in regard to the remaining issues.
Pursuant to local rule, the mediation has been terminated by the mediator.
- B. The appointment of a Child Representative or Guardian ad Litem □ is □ is not recommended in accordance with Local Rule 14.08(8)(H).
- C. □Mediation continues with the next session scheduled on _____ and it is anticipated that an additional _____ days will be needed to complete the process.
DATE:___
NAME:___
ADDRESS:___ SIGNED:___
PHONE:___
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