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Departmental Appeals Board

Sample Agreement to Mediate~Additional Confidentiality

The parties voluntarily agree to mediate. The parties understand that mediation may be terminated at any time by either party or by the mediators.

The mediators have no authority to decide any case and are not acting as advocates or attorneys for any party. The parties have a right to representation during mediation.

The confidentiality provisions of the Administrative Dispute Resolution Act apply to this mediation. The ADR Act focuses primarily on protecting private communications between parties and the mediator. Generally, parties oral communications to the mediator during mediation are protected. The same is true for written communications parties prepare for mediation and give only to the mediator.

The parties understand that the ADR Act does not protect oral communications made with all the other parties present or documents a party makes available to all other parties. The parties further understand that they can contract for additional confidentiality and they agree to do so in this matter. Specifically, they agree that oral communications made with all the other parties present or documents a party makes available to all other parties will be confidential in this mediation. Finally, the parties understand that despite this agreement for additional confidentiality, outside parties may still have access to statements or documents as provided by law (e.g. the Freedom of Information Act).

In unusual circumstances, a judge can order disclosure of information that would prevent a manifest injustice, help establish a violation of law, or prevent harm to public health and safety. Further, information concerning fraud and criminal activity or threats of imminent harm will not be considered confidential in this mediation.

No party shall be bound by anything said or done at the mediation, other than this Agreement to Mediate, unless a written settlement agreement is reached and executed by all necessary parties.

By signature below, we acknowledge that we have read, understand, and agree to the terms of this Agreement to Mediate.


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Mediation at the Departmental Appeals Board
Sample Agreement to Mediate
Standards of Practice for HHS Mediators

Last revised: November 20, 2003


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