Mediation Appointment: Divorce, Legal Separation, and Parenting

The first step toward resolving your divorce and parenting issues is to request a mediation appointment. Either call 603.654.500 or fill out and submit this form. If you use the form, her staff will contact you the next business day.

Note: There is a charge (fee) for every appointment. It is not possible for Ms. Hastings to meet with every person who submits a request.

SESSION TYPE
Family Mediation of NH offers 2 types of first appointments.
Please select the type of appointment you want.
Information Session (30 minutes)

  • Find out how mediation works and how it could help you.
Working Session (2 hours)

  • Review the mediation process.
  • Determine what issues need to be mediated.
  • Get started on working them out.
In requesting an appointment, you agree to the following:

  • We understand that the purpose of mediation is to work out an agreement that will resolve our issues. We have one or more issues to work out and are seeking the assistance of Family Mediation of NH to do so.
  • We understand that the fee must be paid in cash or check, at the beginning of the session.
PARTIES
Family Mediation of NH needs information on both spouses, parents, or other people seeking mediation.
Your Information
Name:
Street/PO Box:
City:
State, Zip:
Phone Daytime:
Phone Evening:
Cell Phone:
Email:
Lawyer:
Information about the Other Party
Name:
Street/PO Box:
City:
State, Zip:
Phone Daytime:
Phone Evening:
Cell Phone:
Email:
Lawyer:
INFORMATION NEEDED
a. What is your relationship to the other party?

Specify if Other:
b. How many children do you have with this spouse or other person who are
under the age of 11?
How many children do you have with this spouse or other person who are
between 11 and 18 years of age?
c. Has a petition been filed in court? Yes

No
d. What are the topics or issues you need help with? Check all that apply.
Parenting Plan Support/Alimony
Dividing Assets Dividing Debts
Family Home Retirement Plans
Small Business Prenuptial Agreement
Other (please specify)
SCHEDULING
What times are both of you generally available for mediation? Please list specific days of the week for the specified times. (Example – Wednesday mornings and Thursdays after 3 pm.)

Please Note: When we confirm the appointment time,
we will ask you to supply a MasterCard or Visa number.

If you have questions about filling out this form,
or about fees, call 603.654.5000.