Make an Appointment for a MIAM - Ourkidsfirst Mediation

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Which areas would you like to discuss in mediation

Please provide brief details of the issues ?

Have you previously used an MOJ £500 voucher for mediation??

If you are currently in legal proceedings please provide your case number?

Your First Name

Your Last Name

Your Phone/Mobile Number

Your Email

Your date of birth

Your Occupation

Do you receive universal credit?

National Insurance Number ( legal aid only)

Ethic Origin

Your Address

Address Line 1

Address Line 2

City

Post Code

Your Childs Name

Gender

Childs Date of Birth

2nd Childs Name

Gender

2nd Childs Date of Birth

3rd Childs Name

Gender

3rd Childs Date of Birth

OTHER PERSONS First Name

OTHER PERSONS Last Name

OTHER PERSONS Phone/Mobile

OTHER PERSONS Email

OTHER PERSONS Date of Birth

Other persons Occupation

OTHER PERSONS Address

Address Line 1

Address Line 2

City

Postcode

Does the other person receive Universal Credit?

Are there any injunctions, PIN, Non Molestation orders or bail conditions in place?

Have the police ever been called by you or the other person?

Have children social services been involved with you or the other person about your children?

Please provide times, days, that you can make a 1 hour MIAM appointment?

I have read and agree to the Refunds Policy and Privacy Policy

Solicitor Notification Consent

Solicitor/ Legal Support Notification Option

We will not share information from your meeting with your solicitor or the other persons Solicitor.

However, we can operate a notification service for you and your legal advisor/ supporter to keep them updated when any of the following happen

you are informed if mediation is proceeding

you receive a certificate of attendance at a MIAM

you receive a mediation summary or documents

you are looking for a consent order – Form A/ Tolata

if your mediation has broken down

We do not charge for this service, as it helps you and your legal support avoid delay. This will be an automated text/ email message to your solicitor , which will be one line. Some Solicitors may charge and some may not.

I agree to give consent for notifications only to my legal advisor / support.

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