The most important predictor of a successful mediation is having all the decision-makers present in person with full, unshared control over final settlement decisions. Fairness requires that all parties know in advance who is coming and under what (if any) restrictions. This Form must be completed and faxed to me and all other participating attorneys within seven days after a date is confirmed. Any party that fails to fax this form on time shall be charged for any cancellation, postponement or other problem causally related thereto.

1.	Your name: Name of case: Party you represent:
2.	Name and title/relationship to the case of each person who will accompany you:
3.	Before a settlement agreement can be signed, is there anyone else you might have to contact (e.g., a spouse; a lienholder; another company employee for more authority)? Do not respond "No" unless you and whomever you bring will have full, unshared control over all decisions regarding settlement. ___NO ___YES - Name(s) and title/relationship to the case (e.g."Kim Jones, VP Claims, may have to be called depending on how the negotiation goes"):
4.	If you answered #3 "Yes", why will the named individual(s) not be present?

In the event of changes, you have a duty to immediately update your responses.

If you receive a Form with "Yes" checked off in Question #3 and you believe that the absence of that person will unduly impact the negotiation, you should immediately advise the rest of us that you do not wish to proceed.
Your cooperation in this step will protect us all from wasting valuable time later.