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Individual Forms

Child-Centered Mediation Agreement (for existing Parenting Plan Cases)

Child-centered Mediation Agreement

Consent to Contact and Mediate with Minor Child(ren)

Child-centered mediation seeks to find ways to include the voices of children as parties in the process of developing a parenting plan. The decision-making authority and responsibility of any plan remains solely with the parents. Children will not be asked to make decisions. The intent of any individual or joint mediation session involving minor children is to provide an opportunity for a child’s voice to be heard by the family in a safe environment that facilitates familial communication. 

Mediators trained in this process (Child Consultants) assess the appropriateness and potential value of involving minor children in the mediation process. When child(ren) are invited to attend a meeting with a Child Consultant: 

  • The Child Consultant will determine the best stage of the process for meeting with child(ren). 
  • Child(ren) only meet with the Child Consultant if they agree to do so. 
  • Once brought into the process, child(ren) may request to talk to/meet with their Child Consultant. 
  • Child Consultants take every precaution to ensure that children’s emotional safety and stability will not be compromised during the mediation process. For this reason, child(ren)’s meetings are confidential. 
    • Confidentiality will be explained to each child as their “private” time but not “secret” time. 
      • The child may say anything about his/her time with the Child Consultant to anyone that s/he would like. 
      • The child may ask to attend a meeting with his/her parent(s) and the Child Consultant to directly share items, or s/he may ask the Child Consultant to relay information to the parent(s). The Child Consultant will ensure that s/he confirms with the child the approved issues to share prior to discussing with the parent(s). 
      • The child may choose to remain private and not share anything at all about his/her time with the Child Consultant. Mediation West will adhere to the child’s wishes regarding items that will not be shared with others during the mediation process, including parent(s). The only exceptions will be if a child makes a disclosure of unreported abuse or neglect, or that s/he is at risk or is aware that another person is at risk. 
  • Parents may also wish to hold a session with their child(ren) after establishing a parenting plan so they can share that plan with their child(ren) in the presence of a mediator. 

Child(ren) involved in child-centered mediation typically have two one-hour private sessions; these sessions are for the child(ren) and the Child Consultant only and may not be attended by anyone else, including a parent or attorney. These sessions must be in person at the mediation center, or a location approved by the Child Consultant and cannot be done via technology, such as telephone or video conference. Child(ren) may also have a joint session with parent(s), may ask for information relayed to parent(s), or the Child Consultant will meet with the parents to share if their observations show typical behavior and maturity for the child(ren)’s age(s) or if there are potential areas for concern. 

Parents giving consent for their child(ren) to participate in the mediation process should be committed to allowing their child(ren) to continue if the child(ren) see value in it. Prematurely severing their participation may have negative consequences for the child(ren). Parents are encouraged to seek legal advice before signing any consent if they have any questions.

Please select one of the following:
Please select one of the following:

Sign Below

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. 

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