Virtual Mediation Solutions - START HERE - virtualmediationsolutions.ca

Reach out today

Please use the message as an opportunity to provide a brief description of the matter(s) you would like to address: Thank you for taking the time to contact me and I look forward to connecting and providing a quote.

Step 1 of 4

Please take a few moments to answer this questionnaire. This document is strictly confidential and will be seen only by our office personnel. Please mark clearly any information, which you are uncomfortable discussing with the other party in mediation.
Today’s date*
MM slash DD slash YYYY
*Please help us understand what type of family mediation you need assistance with.
Please help us understand what type of family mediation you need assistance with*
- On-site court mediation-you have a pending court date, so someone (court staff, judge, lawyer) recommended mediation in regard to all issues related to your children.
- Off site-you are not in court you have issues to resolve for your children spousal support and or property financial issues.
Upcoming Court Date:*
MM slash DD slash YYYY
Purpose
What is current Court Order or Agreement?
Is it being followed at this time?
Referred By*
- Judge
- Lawyer
- Self
- Courts Staff
- Other

General Information
Name*
First Last
Date Of Birth*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Employer*
Job Title*

Reach out today

Step 1 of 4

50% OFF!

Your Entire Divorce Mediation Process

CALL 705-715-1833 to Reserve