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Monmouthshire Mediation Practice Referral Form
Web Site
Your Details
Full Name
*
Address
*
Telephone
*
Email
*
Name of Representatives (if any)
Address
*
Telephone
*
Email
*
Other party's details where know
Full Name
*
Address
*
Telephone
*
Email
*
Name of Representatives (if any)
Address
*
Telephone
Email
*
Details of the dispute - please complete all of the boxes below
Brief description of dispute (including value, and location where it is a property dispute)
*
Have proceedings been issued; if so, when and by which party?
*
What are the costs incurred by you to date (including legal and court costs) in the dispute?
*
What are the estimated costs of pursuing the dispute to trial / tribunal / arbitration (if relevant)?
*
Other information
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