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Family Mediation Consortium
Advantages of Mediation
Cost of Mediation
MIAM
Contact Us
Referral Form
"An easier transition for children and other family members."
Referral Form
First Party Details
Title*
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Mr
Mrs
Ms
Miss
Other (Please Specify)
Name*
Address*
Home Telephone*
Work Telephone
Mobile Telephone
Email Address
First Party Solicitor Details
Firm Name
Address
Telephone
Fax
Email Address
Contact Name
Second Party Details
Title
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Mr
Mrs
Ms
Miss
Other (Please Specify)
Name
Address
Home Telephone
Work Telephone
Mobile Telephone
Email Address
Second Party Solicitor Details
Firm Name
Address
Telephone
Fax
Email Address
Contact Name
Other Details
Issues for Mediation
Select One
Children
Property and Finance
All Issues
Have you/your client ever been referred to our service before?
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Thank you for your referral, we will contact you as soon as possible.
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