Appendix B Agreement to Mediate

Agreement to Mediate a Dispute.

App. B

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Case No.

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Date

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Mediator

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Referral Source

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County

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Initiating Party

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Responding Party

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Address

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Address

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Telephone

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Telephone

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We agree to participate in the mediation process in an effort to resolve our dispute. "Mediation" means the process of resolving a dispute with the assistance of a mediator outside of a formal court proceeding.

Our rights and obligations under the Dispute Resolution Act, 12 O.S. Supp.1991, § 1801 et seq., and the Rules and Procedures for the Dispute Resolution Act include:

1. We shall meet with a mediator in an informal, confidential setting.

2. The mediator will assist us in discussing and clarifying the issues.

3. We shall cooperate with each other and the mediator in working toward a mutually acceptable agreement to end our dispute.

4. The mediator will not offer legal advice or make any decisions for us.

5. When an agreement is written and signed to end our dispute, all parties will receive a copy.

6. We shall be responsible for protecting our own rights and property through any pending legal proceedings.

We understand that any information received by a mediator or a person employed to assist a mediator is privileged and confidential. However, a mediator must disclose information brought to his/her attention that an elderly person, or a person with disabilities, or a child under the age of eighteen (18) has been physically abused or neglected.

We hereby release from liability the sponsoring agency for any claimed damages arising out of any action, statement, or decision made or taken in the mediation session, except where provided for in the Dispute Resolution Act.

We acknowledge that we have read and understand this Agreement, and we hereby agree to abide by its terms.

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Initiating Party

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Date

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Responding Party

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Date