The forms listed below are in PDF format and can be downloaded or printed. Click a link below to open and view a form.
There are reasons why mediation may not be appropriate in a case and why the court may excuse people from the order to mediate. Mediation may not be appropriate if you are uncomfortable being in the same room with the other person in the case, if you are afraid to speak up or disagree with them in mediation, if you are afraid that if you do speak up or disagree with them in mediation that you or your child(ren) might be harmed later. Mediation may also be inappropriate if a party has mental illness or a substance abuse issue so severe that participation in mediation might not be advisable. To apply, complete the Application for Waiver from Mediation form and present it to the Clerk of Court’s office in your local courthouse. There are additional reasons mediation might be appropriate. If you have any questions about this, please contact 319 248-1940 or email firstname.lastname@example.org
If you are low-income, you can apply to have a Pro Bono mediator appointed in your case. To apply, complete the Application for Appointment of Pro Bono Mediator and Financial Statement and the Financial Statement form (Application for Deferral of Fee, Costs, or Security and Financial Statement) and present them to the Clerk of Court’s office in your local courthouse. If it is determined that you qualify, a mediator will be assigned who will charge you a reduced fee for your share of the cost of mediation. Both individuals can apply separately to qualify for the reduced fee.