Mediator Forms, Steps & Information

Gain valuable legal experience and increased visibility when you serve as a mediator in our CCCBA program.

Join Us—Submit Your Application

Fee Arbitrator & Mediator Volunteer Form: Fill out this easy one-page volunteer form and return it to us. Mail, fax or email the form this form to us.

Once we receive your form and determine if you qualify to be a CCCBA Mediator, we will notify you with a “thank you” in email.

CCCBA will then place you on the list of available mediators. Thank you again, for contributing to this valuable community program.

Rules of Procedure for the Hearing of Fee Arbitration & Mediations

back to top

Assignment Letter & Statement of Disclosure

A notice of assignment is emailed to you for your consideration. The email includes the names of all parties—please conduct a conflict of interest check. A deadline to respond yeah or nay will be noted.

Once you accept an assignment, the file will be mailed to you along with instructions and the necessary forms to complete your duties.

Mediator Statement of Disclosure Form: Please fill out the following disclosure form and return it to the CCCBA by the date indicated in the assignment letter.

If you find that for any reason you are unable to serve as a mediator, please call CCCBA immediately and return the file to our office.

back to top

Agreement to Mediate

All parties, including you, will be notified of your assignment as mediator upon receipt of your disclosure form here in our offices.

Agreement to Mediate Confirmation Form: Within 10 days after receiving your Assignment Letter, you should contact the parties and arrange a date for the mediation. Use this form.

The mediation should be held no later than 30 days from the date you received your Assignment Letter, or as soon thereafter as possible.

If you wish, you may conduct the mediation at our CCCBA offices. Call Emily Day, Arbitration Coordinator, to check on availability and to schedule the mediation.

It is a good idea to contact all the parties involved first and arrange a list of several dates and times that work with everyone’s schedules.

back to top

At the Hearing

Acknowledgement of Confidentiality of Mediation Process Form: At the onset of the mediation, please have all participants in the mediation sign this form.

Before they leave, give each participant a copy of the signed document and mail the original to CCCBA.

Fee Mediation Settlement Steps

Fee Mediation Settlement Agreement Form: If the parties reach a settlement agreement at the mediation, please download this form for the parties to fill out and sign/date.

Give each party a copy and mail the original to CCCBA. We will serve the “Notice of Rights After Mediation” and close the file.

If no settlement agreement is reached, you should notify CCCBA in writing and the matter will proceed to arbitration in accordance with the Rules of Arbitration.

back to top

Contact Us & Mail Your Forms

If you have any questions after reviewing the material in this section, or to mail any forms:

Emily Day
CCCBA Fee Arbitration Coordinator
2300 Clayton Road, Suite 520
Concord, CA 94520

Phone: (925) 370-2541
Fax: (925) 686-9867
Email:

back to top