MEDIATION APPEALS PROGRAM EVALUATION
Mediator Name:
Case Name:
Docket Number:
Evaluation
Overall Rating of Mediator’s Skills/Abilities
Excellent
Good
Fair
Poor
Mediator explained the process
Excellent
Good
Fair
Poor
Mediator kept the mediation moving along
Excellent
Good
Fair
Poor
Mediator maintained neutrality
Excellent
Good
Fair
Poor
Mediator asked insightful questions
Excellent
Good
Fair
Poor
Mediator enhanced the negotiations
Excellent
Good
Fair
Poor
Mediation Process
Did the Mediation help you understand the other parties’ position?
Yes
No
Did the mediation help to resolve the dispute?
Yes
No
Based on your experience, would you use the process again?
Yes
No
If no, please explain:
What was your role:
(Please Choose One)
Appellant
Agency Official
Union Official
Attorney/ Appellant/Agency
Non-Attorney Appellant/Agency
Other
Do you have any suggestions to improve the Mediation Appeals Program?
(Please explain below:)
Yes
No