DISPUTE RESOLUTION PROGRAMS - CIRCUIT EXECUTIVE'S OFFICE

UNITED STATES COURTS 

DISTRICT OF COLUMBIA CIRCUIT
				     (Case Number (06.0722) (Study No. 3207.06)
		
Mediation User Survey Form
					
PLEASE FILL OUT THIS FORM AS SOON AS THE MEDIATION PROCESS IS COMPLETED AND RETURN IT TO:	
					Circuit Executive's Office - ADR Programs
					E. Barrett Prettyman U.S. Courthouse
					333 Constitution Avenue, NW     
					Room 4726                                                     
					Washington, DC 20001
					(Phone- 202/216-7343)
                                      (Fax-202/273-0331)					              
											
1.   Name of Mediator: David Lewis, Esquire 
2.   Case Name: 3D Global Solutions v. MVM
3.   Are you the:    ☐ Plaintiff's attorney      ☐ Defendant's attorney      ☐ Other                               
4.   Date(s) of Mediation Session(s):       /    /    ,      /   /   Outcome:  ☐ Settled  ☐  Not Settled
5.   Type of Case (Contract, Tort, etc.): ___________________________________________________
6.   Mediator's level of participation:	None		Low		Medium	    High

PLEASE EVALUATE THE MEDIATOR IN EACH OF THE FOLLOWING AREAS BY CIRCLING THE NUMBER THAT BEST REPRESENTS YOUR OPINION OF HIS/HER PERFORMANCE IN THIS MEDIATION:

									                      Very 
								    	        Excellent     Good     Good        Fair       Poor
				
7.  Explanation of the mediation process					5	   4	    3	       2	1

8.  Willingness to listen to your client's side of the case			5	   4	    3	       2	1

9.  Understanding of the FACTUAL issues involved in the case		5	   4	    3         2	1

10. Understanding of the LEGAL issues involved in the case		5	   4	    3	       2	1

11. Use of appropriate questions to determine facts of the case		5	   4	    3	       2	1

12. Ability to clarify the key issues and interests of each party		5	   4	    3	       2	1

13. Ability to help the parties generate realistic settlement options		5	   4	    3	       2	1

-OVER-

										
                        							                       Very 
								                    Excellent   Good     Good        Fair       Poor

14. Ability to move the parties toward consensus			         5	   4	    3	      2	       1

15. Ability to resolve impasses between the parties		        	  5	   4	    3	      2	       1

16. Mediator's tone, body language, and demeanor		                 5	   4	    3	      2	       1

17. Overall, do you believe the mediator was impartial and treated both sides fairly and equally?
				 ☐  YES         ☐  NO

18. Overall, how satisfied were you with the mediation PROCESS?

		3  Very Satisfied		2  Satisfied		1  Dissatisfied	

19. Overall, how satisfied were you with the mediator?

		3  Very Satisfied		2  Satisfied		1  Dissatisfied	

20. Overall, how satisfied were you with the OUTCOME of the mediation?

		3  Very Satisfied		2  Satisfied		1  Dissatisfied

21. Do you think mediation was appropriate in this case?      ☐  YES         ☐  NO

PLEASE EXPLAIN:

PLEASE EVALUATE the court brochure titled Mediation in the United States District Court
for the District of Columbia.  Did the brochure help you decide to consent to mediation in this
case?	         ☐  YES         ☐  NO

FOR ADDITIONAL COMMENTS, PLEASE ATTACH ANOTHER SHEET.