LCAM Mediation Booking

refer a mediation

Step 1 of 2

This form is a request to book a mediation.

LCAM will contract all parties to the mediation to confirm the details provided.

For disputes with more than two parties, please contact LCAM directly.

The parties

Name of the parties to this mediation

Please provide the names, addresses, and contact details of the Parties to this mediation

Party A/Claimant

Name

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone

Party A/Claimant representation

Name

Company name

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone

Party B/Defendant

Name

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone

Party B/Defendant representation

Name

Company name

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone

The Dispute

Claim

Please provide the value of the claim

Is there a counter claim

Industry and Sector type

Summary of dispute

Please provide a general summary of the dispute

Additional information about the dispute

Click or drag files to this area to upload. You can upload up to 5 files.

The mediator

Mediator

LCAM selects and appoints a mediator
Parties have agreed a mediator
Ask for mediator recommendations

Date of the mediation

Please provide the agreed date or the dates the parties are available for mediation

Venue

Where will the mediation take place:

33 Queen Street, London EC4R 1AP
Other venue

What is the address where the mediation will be held?

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Additional information

Phone