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Assessment: Mediation Needs and Family Circumstances

Please take this assessment for recommended services or resources for your family. 

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General Questions

What best describes your current circumstances and your interests in mediation? 

Question 2 of 12

What is the status of your relationship?

A

Divorced (with legal agreement)

B

Separated (with legal agreement)

C

Never married, never lived together. No legal agreements in place.

D

Living apart. Division of property, child support, and/or spousal support have not been addressed.

E

Still living together with both parties in agreement to move towards separation and/or divorce.

Question 3 of 12

Do you want mediation to help improve communication?

A

Yes, we want support now and tools to carry into the future.

B

No. We are currently communicating well.

C

No. We just need to make decisions.

D

No. I am unwilling to communicate with them in the future.

Question 4 of 12

Do you want mediation to result in parenting decisions?

A

Yes. We will be co-parenting and want to have agreements about the issues that are important concerning our child(ren).

B

Yes. We need to make decisions about arrangements for parenting time and a parenting plan about long term, big picture topics.

C

No. One of us will be the primary care-giver and make all or most of the decisions.

D

No. We only need mediation to navigate property division.

Question 5 of 12

Are you willing to have collaborative discussions?

A

Yes, we need to come to agreements together.

B

No, I need the other party to compromise and if they are unwilling I will need to consider going to court.

Enforcement Needs and Complexities

Let us know if there are any circumstances that may complicate your situation where you might need additional support. 

Question 7 of 12

Are you seeking enforcement of child support?

A

Yes

B

No

Question 8 of 12

Are you seeking enforcement of parenting time?

A

Yes

B

No

Question 9 of 12

Is there a personal business attached to either parent? 

A

Yes

B

No

Question 10 of 12

Is there CFS involvement in the family?

A

Yes

B

No

Question 11 of 12

Is there an active, pending, or expired no contact order with the other person or a child?

A

Yes

B

No

Question 12 of 12

Do you have any safety concerns meeting with the other person? 

A

Yes

B

No

Confirm and Submit