Mediation Evaluation Survey

Please take a few minutes to complete our survey. You can either download it and then mail or fax the completed form to us or you can complete our online survey form below.

The results will be used to document the effectiveness of family law mediation in Polk County. Participating in this study may provide you with a sense that you have contributed to increasing the understanding of and improving the process of divorce and family mediation services. Your participation is strictly voluntary and you are free to decline. Efforts to protect your confidentiality will be maintained.

Please take a few minutes to complete this survey. The results will be used to document the effectiveness of family law mediation in Polk County. Participating in this study may provide you with a sense that you have contributed to increasing the understanding of and improving the process of divorce and family mediation services. Your participation is strictly voluntary and you are free to decline. Efforts to protect your confidentiality will be maintained..

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Please agree or disagree with the following statements. (Choose SA for strongly agree, A for agree, D for disagree, SD for strongly disagree and DK/N for don’t know or neither.)