Solicitor Referral Form

Confidential Mediation Solicitor Referral Form

Please complete this form as fully as possible.

 

After submitting the form, you should receive an automated message, followed by an email from the office once they have received the form. If you don’t, please ring the above number to check your referral has been received.

 

Childs name (including surname)
Date of Birth
Living with
Childs name (inc. surname)
Date of Birth
Living with
Childs name (inc. surname)
Date of Birth
Living with
Childs name (inc. surname)
Date of Birth
Living with
Childs name (inc. surname)
Date of Birth
Living with
Childs name (inc. surname)
Date of Birth
Living with
Childs name (inc. surname)
Date of Birth
Living with
YesNo
ResidenceContactFinancial / PropertySeparation/Divorce (e.g. timing, talking to children)Other Matters (please specify):
Kent Family Mediation Service will be able to assess the eligibility of clients for Legal Services Commission payment of mediation fees and any payment will be made directly to the Service.

Having trouble submitting the referral, or have any questions for us? Click here to contact us or call Kent Family Mediation’s main office on 01795 410457.

Family Mediation Services

Family Mediation is the courts preferred way of resolving an argument, or issues that occur after a separation, or the breakdown of a relationship;including sorting out child contact, the custody of a child, child support maintenance and disputes…

More Information

Separated Parents Information Programme

Kent Family Mediation Service are pleased to announce that we have been granted a contract to provide Parenting Information Programmes in Kent on behalf of Cafcass. We hold the SPIP courses in a number of locations in Kent…

More Information

Our Affiliations & Accreditations