Online Intake Form

Online Intake Form

Select type of service needed Mediation or Arbitration 

Select the Neutrals you would like to use for your case 

Select the location of your mediation /arbitration

Do you have a scheduled court date 


Request dates and times  for Mediation/ Arbitration

 

Plaintiff Information








 

Defendant Information









Insurance Company Information








Commonwealth Mediation and Conciliation, Inc
1145 West Chestnut Street
Brockton, Ma 02301
Phone: 508-583-8111   Fax 508-583-8334