Please take a few moments to review and answer the questions below. The purpose of this form is to provide you with an opportunity to share your perspective and for me to better understand your interests in advance of the mediation.

Your identity, should you choose to share it, will be held in strict confidence. Please know that information relating to your perspective and goals relating to the situation will not be reported to anyone and will only be used to help me better understand themes, trends and your interests.

Thank you for taking the time to complete this form.

Thank you very much for taking the time to complete this diagnostic questionnaire. Please contact cdoran@mwi.org with any questions.