Skip to main content

Individual Forms

Small Claims Mediation Form

Request to Mediate a Small Claims Matter

The Court has partnered with Mediation West to offer small claims mediation service. If you have already filed your court case, you can request mediation without submitting a payment by answering the questions below. We will be able to look up all of the information we need to get started using your court case number.

If you have not filed a court case, you can open a mediation case with a reduced fee application and $29 fee by clicking here to enter some information about the situation you hope to resolve and contact information for the other person. 

Please select one of the following:
Funding for the small claims program comes from grant funds that require the following information.
Household Size and Income
Your household size should include all children and adults and household income should include all income from adults.

Sign Below

I agree that clicking the "I Accept" button and entering my full name below shall constitute an electronic signature, constitutes 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. 

Electronic Signature
First Name *
Last Name *