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IIDRC Mediation Intake Form
For Cases Administered under IIDRC Mediation Rules
1. Nature of Mediation
Section 1/7
Type Of Mediation
*
Type Of Mediation
A
Contractual/Commercial
B
Workplace/Employment
C
Partnership/Shareholder
D
Real Estate/Property
E
Other
Mode Requested
*
Mode Requested
A
Physical
B
Online
C
Hybrid
Pre-litigation or Court- referred Field
*
Pre-litigation or Court- referred Field
A
Pre-litigation
B
Court-directed
2. Parties to the Dispute
Section 2/7
Name
*
Organization/ Entity
Email
*
Contact Number
*
Address
*
Opposing Party (Party 2)
Name
*
Organization Field
Email
*
Contact Number
*
Address
*
Are there additional parties to this dispute
*
Are there additional parties to this dispute
Yes
No
3. Mediator Details
Section 3/7
Mediator Selection
*
Mediator Selection
A
Party-requested Mediator
B
Request IIDRC to appoint a suitable Mediator
Preferred Language
*
Preferred Language
A
English
B
Hindi
C
Other
Interpreter Required
Interpreter Required
A
Yes
B
No
4 Dispute Information
Section 4/7
Brief Summary of Dispute
*
Estimated Claim Value (if monetary)
Existing Contractual Clause(if any)
Attach any written communication between Parties
Click to choose a file or drag here
Accepts .pdf, .doc, .docx, .jpg, .png files
5. Requested Mediation Dates
Section 5/7
Ist Preference
*
2nd Preference
*
Number of sessions anticipated
Number of sessions anticipated
A
1
B
2
C
3+
Expected Duration (per session)
Expected Duration (per session)
A
Half Day
B
Full Day
C
6. Confidentiality & Consent
Section 6/7
Please confirm your agreement to the following (all required)
*
Please confirm your agreement to the following (all required)
I/We agree to initiate mediation under IIDRC Mediation Rules
I/We acknowledge the confidential nature of the proceedings
I/We agree to data handling under IIDRC's Privacy Policy
I/We understand that the mediation is voluntary and non-binding unless a written agreement is reached
7. Billing & Contact for Invoices
Section 7/7
Name of Invoices
*
Billing Email
*
GSTIN / PAN ( If Indian entity)
*
Payment Responsibility
*
Payment Responsibility
A
Applicant
B
Shared
C
TBD by parties
Date of Submission
*
Submitted by
*
Digital Signature
*
Signature
Submit
