Referrals to Community Mediation

Referral Made By *

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Last

Your Position

If Other, Describe

Your Email *

Party 1 *

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Last

Contact Information for Party 1

Please include any or all of the following: mailing address, phone number(s), email address

Party 2 *

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Last

Contact Information for Party 2

Please include any or all of the following: mailing address, phone number(s), email address

Additional Parties Involved and Contact Information, If Applicable

Your Position for

Next Court Date, If Applicable

Nature of Situation/Dispute

Case/File Number(s)

County *

Anything else you want to share?

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50 S FRENCH BROAD AVE

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Asheville, NC 28801-3271