Templates Universal Mediation Summary for Mediator
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Mediation Summary for Mediator

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MEDIATION SUMMARY FOR MEDIATOR

CONFIDENTIAL MEDIATION COMMUNICATION
Protected by Mediation Privilege

BASIC INFORMATION

Field Information
Submitting Party: _________________________________
Attorney/Representative: _________________________________
Phone: _________________________________
Email: _________________________________
Case/Matter Name: _________________________________
Case Number (if any): _________________________________
Mediation Date: _________________________________
Mediator: _________________________________

1. THE DISPUTE IN BRIEF

Summarize the dispute in 3-5 sentences:

___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________

2. PARTIES

Our Client:

  • Name: __________________________________________
  • Role: __________________________________________

Opposing Party:

  • Name: __________________________________________
  • Counsel: _______________________________________

Other Parties (if any):

___________________________________________________

3. KEY FACTS

List the 5-10 most important facts:

  1. ________________________________________________
  2. ________________________________________________
  3. ________________________________________________
  4. ________________________________________________
  5. ________________________________________________
  6. ________________________________________________
  7. ________________________________________________
  8. ________________________________________________
  9. ________________________________________________
  10. _______________________________________________

4. DISPUTED ISSUES

Identify the main areas of disagreement:

Issue Our Position Their Position
____________ ____________ ____________
____________ ____________ ____________
____________ ____________ ____________
____________ ____________ ____________

5. DAMAGES CLAIMED

Category Our Client Claims Opposing Party Claims
Economic Damages $____________ $____________
Non-Economic Damages $____________ $____________
Other $____________ $____________
TOTAL $____________ $____________

6. PRIOR SETTLEMENT DISCUSSIONS

☐ None
☐ Yes - Most recent positions:

  • Our demand/offer: $____________
  • Their demand/offer: $____________
  • Gap: $____________

What happened:
___________________________________________________
___________________________________________________

7. WHAT WE WANT FROM MEDIATION

Primary Goals:

  1. ________________________________________________
  2. ________________________________________________
  3. ________________________________________________

Settlement Range:

  • Opening: $____________
  • Target: $____________
  • Authority: $____________

8. OBSTACLES TO SETTLEMENT

What do you see as the main barriers?

☐ Factual disagreements about: _________________________
☐ Legal issues regarding: _____________________________
☐ Valuation gap: ____________________________________
☐ Emotional/relationship issues: _______________________
☐ Authority limitations: ______________________________
☐ Third-party issues (liens, insurance): _________________
☐ Other: ___________________________________________

9. WHAT WOULD HELP

What could the mediator do to help move this case toward resolution?

___________________________________________________
___________________________________________________
___________________________________________________

10. ATTENDEES AT MEDIATION

Name Role Settlement Authority
____________ ____________ ☐ Full ☐ Limited
____________ ____________ ☐ Full ☐ Limited
____________ ____________ ☐ Full ☐ Limited
____________ ____________ ☐ Full ☐ Limited

Person with final settlement authority:
☐ Will be present
☐ Available by phone/video at: _________________________

11. SENSITIVE MATTERS

Anything the mediator should know about dynamics, personalities, or sensitivities:

___________________________________________________
___________________________________________________
___________________________________________________

12. KEY DOCUMENTS

List 3-5 most important documents (attach if requested):

  1. ________________________________________________
  2. ________________________________________________
  3. ________________________________________________
  4. ________________________________________________
  5. ________________________________________________

13. TIMELINE

Date Event
____________ _________________________________
____________ _________________________________
____________ _________________________________
____________ _________________________________
____________ _________________________________

14. LITIGATION STATUS

☐ No lawsuit filed
☐ Lawsuit pending:

  • Court: _________________________________________
  • Trial date: _____________________________________
  • Next deadline: __________________________________

15. ADDITIONAL COMMENTS

___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________

Submitted by:

Signature: __________________________________________
Date: ______________________________________________

CONFIDENTIAL - FOR MEDIATOR USE ONLY

This template is provided for informational purposes only and does not constitute legal advice. Consult with a qualified attorney before use.

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About This Template

These universal templates are drafted for general use across the United States, without being tied to one specific state's statutes or court rules. They work as a starting point for documents where the subject matter is governed mainly by federal law or by legal concepts that are broadly similar everywhere. For state-specific versions with local citations and filing rules, look for the jurisdiction-tagged version of the same template.

Important Notice

This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Last updated: February 2026