Group & Meeting Facilitation Inquiry Form

Client Information

Case Information

Please explain briefly what issue(s) you would like to address during a facilitated discussion(required)
How many people are expected to participate in the meeting/conference?
Do you currently have a date set for the facilitated event?
Yes No
How long do you expect the event to last? (i.e. 3 hours, one full day, etc.)
Where is the event scheduled to occur?
Other party(s) names(s) and daytime contact information (these parties will not be contacted until further discussion with you regarding the process and availability of facilitation for your event):
First Name Last Name Position Phone# E-mail
What is your relationship to the other parties?
Is facilitation required by a contract related to this case?
Are the issues to be addressed via facilitation part of a current court case?
Yes No
If yes, please provide the following:
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Court
Type of hearing
Hearing date (mm/dd/yyyy)
Case number
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Additional Comments/Questions

“Facilitation”