Off-Site Family Mediation Intake Form (No court case required)

 

Privacy & Confidentiality

Everything you share in this form is strictly confidential and forms part of a closed mediation process. We will not share your information with anyone without your consent, except in the following circumstances required by law:

  • A child is at risk of harm
  • A person is in imminent danger
  • A judge orders disclosure

Your information may also be used for research or training purposes, with all identifying information removed.

Before You Begin — Please Note:

  • Each party must complete and submit their own separate form. Mediation cannot proceed until intake forms have been received from both parties.
  • Have your photo ID ready to show the mediator at your intake appointment.
  • This form takes approximately 15 minutes to complete.
  • Digital security notice: While we take all reasonable steps to protect your information, we cannot guarantee that electronically submitted data is 100% secure.
Please have PDF or JPEG copies of the following documents ready to upload when prompted (if applicable):


Family Law Information Centres (FLIC)

You can learn much more about available services, mediation, court process, separation, divorce and the law by visiting us at one of our Family Law Information Centres (FLIC).

416-977-0718

361 University Ave, Suite 146, Toronto, ON M5G 1T3

Get Directions
416-326-1694

311 Jarvis Street Toronto, Ontario, M5B 2C4(Between Gerrard and Dundas)

Get Directions
416-250-6161

47 Sheppard Avenue East Toronto, Ontario M2N 5X5Main Floor (Just east of Yonge, south side of Sheppard)

Get Directions
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