Thank you for considering Mediation West for your mediation needs!
If individuals choose any of the following:
They retain their right to resolve their issues through the use of a private mediator, the self-help section on the Nebraska Supreme Court Website, through a settlement conference between their attorneys, or any other means approved by the Court.
I am choosing to move forward with a voluntary case using Mediation West’s services and by doing so I acknowledge and agree to Mediation West’s Code of Conduct as stipulated in their Policy.
Fill out the form below to participate in an OPEN parenting plan case and apply for reduced fees.
If you want to participate and pay full fees, please complete this form instead.
If you need to mediate issues not related to a parenting plan, please complete this form instead.
Before you begin make sure to have the following:
By signing below, you consent to mediate with the other parent identified above according to terms of current Mediation West Policy. To read the full policy click here. Highlights of the policy include:
Recordings/transcriptions of sessions are not admissible in court and allowing other people to listen to sessions is strictly forbidden and may void any agreement reached.
Mediation West may share information about your case under certain circumstances (to read the full policy click here). If you would like us to release/receive information to/from someone, we need your authorization by checking the corresponding box below:
Fees for services are due and payable before sessions can be scheduled and refunds are limited (to read the full policy click here). When opening your case today, you will need to submit a $39 payment, complete the reduced fee application below, and upload the required income verification. Once your application for reduced fees is processed, you will receive a link with the balance due and instructions for submitting your payment.
Mediation West offers a sliding fee scale based on your household size and income. You will need to provide income verification for each adult counted in your household size to pass audit requirements.
With my electronic signature, I certify that as of today’s date, my gross household income and the number of people living in my household are as I have indicated above. I understand that this information will be used in determining my eligibility for participation in the reduced fee grant program which utilizes federal and state funds; falsification of claims made on this application may subject the reporting party to federal or state penalties.
To read the full policy on Child-centered mediation, click here. Highlights include:
Children are not asked to make decisions; parents are given the opportunity to hear from them how parenting from two households is affecting them.
Children’s time with their consultant is explained as private but not secret. Children are free to share anything they would like about the activities they participate in; parents agree not to push for children to share if they choose not to.
Children may choose to meet with parents before the parents mediate. Children may choose to deliver messages to the parents through their consultant. Children may have no messages for parents directly and parents may only receive a report from the consultant.
As a Nebraska ODR-approved mediation center, Mediation West is subject to reporting requirements which includes the following statistical information. Your answers to these questions will assist us in completing these reports.
I agree that clicking the "I Accept" button and entering my full name below shall constitute an electronic signature, and along with processing my payment, constitute valid evidence of my consent to mediate under the policies of Mediation West. I understand I am solely responsible for reviewing and understanding all the terms and conditions. I agree the electronically stored copy of this consent is enforceable to the same extent as if the documents and records were originally generated and maintained in printed form.