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PHILIP CRUMP Mediator & Facilitator AGREEMENT TO MEDIATE This
Agreement is freely entered into by (print names) and mediator
Philip Crump of Santa Fe, New Mexico. The signatures below indicate that all
parties understand and agree with these terms. 1. MEDIATION is an informal,
democratic and voluntary process in which you create your own mutually acceptable
resolutions of disputed issues. I will
not decide or make you agree to anything, only help you communicate fully and
clearly. “Self-determination” means
you each retain fully independent decision-making authority. Mediation provides an opportunity for you
to focus on how things could be in the future. Success depends in part on your willingness
to participate. 2. NEUTRALITY: Mediators are neutral and impartial
facilitators. I
do not gain from any specific outcome and do not take sides. My primary goal is to create a safe
environment in which you may explore alternatives. I rely on you to tell me what you
need. I provide neither legal advice nor
psychological counseling. Prior to the
mediation, I will disclose any affiliations with any of you or any biases
related to the issues. 3. CONFIDENTIALITY:
Confidentiality fosters safe and open communication.
Mediation discussions are strictly private. Except by agreement, all written and oral
communications made in the course of mediation are confidential, consistent
with the NM Mediation Procedures Act (NMSA 44-7B). Experts providing advice with respect to
any issues in mediation must adhere to the same rules of
confidentiality. I am legally required
to report allegations of child abuse or threats of harm to self or
others. You agree not to call me as a
witness in any judicial proceedings and not to subpoena or demand any notes
or records of the mediation. If you
agree, I may discuss elements of the case with your contracted attorneys or
other professionals*. 4. OUTCOME: With your concurrence, I may document your terms of
resolution in a written Memorandum of Agreement. Signed written agreements may be disclosed
to others. Settlement documents may be
reviewed by legal counsel prior to signing.
As appropriate, you may consult
Legal Counsel to help with questions concerning legal rights, obligations and
interests. 5. COMMITMENT: Resolution of the issues calls for sincere
effort. You agree that, to reach a fair
settlement, you will do your best to maintain open, honest and constructive
communication; to disclose relevant information; to exercise appropriate
self-management of emotion; to take appropriate personal responsibility; and
not to use mediation for legal discovery or retaliation. 6. TERMINATION: If any of us believes that full resolution
cannot be reached
or that further mediation will not prove fruitful, we may make a joint
decision to suspend or terminate mediation.
A written agreement may express this decision and any plans for
subsequent activities that may help resolve the issues. I can help you plan reasonable next steps. 7. FOLLOW-UP: If you wish, I will contact you after mediation, to confirm the durability of
agreements or to determine whether you wish to continue the mediation, to
reinforce the success of agreements.
Return to mediation provides a means of “fine-tuning” agreements,
especially for long-term continuing relationships. 8. TO ENHANCE
COMMUNICATION: We agree to let each
other speak without interruption, to make a good faith effort to resolve the
problem, to speak with respect for ourselves and others, and to be as honest
and open as possible. 9. OTHER: . 10. FEES:
PAYMENT DUE AT TIME OF
SERVICE
(cash or check only, please), Direct mediation, research, preparation,
follow-up: $ per hour. This
also will include One-time case startup fee: $ . Travel: $ per hour, or . Expenses will be
billed at cost. Other: . NM Gross Receipts Tax (8.1875%): included added tax-exempt (NTTC) Minimum charge: $ .
After hours, the rates given above will apply. RETAINER: $ ; Work will be invoiced; any
overage refunded at the end of the case. __ Payment made equally by all parties or . __ Individual
consultation paid by
each individual or .
__ There will be a
charge for missed or delayed appointments (minimum one hour). Note: All charges will
be billed at the hourly rate, in quarter-hour increments. 11. OTHER
FEE-RELATED ITEMS: . DO NOT SIGN THIS FORM UNLESS YOU UNDERSTAND IT AND
FREELY AGREE TO MEDIATION •
We have each read and understand this Agreement to Mediate. •
We freely and fully agree to these terms for mediation.
Date Date
Date Date Date Date
Date Philip Crump,
Mediator Date * RELEASE: In accord with the
Confidentiality provision (#3), we agree that the mediator may discuss
pertinent aspects of our situation with our attorneys, therapists or other
professionals who are helping us reach mutually satisfactory decisions. Initials: |