Harris E. Weinberg Mediation

To submit a case for scheduling, you may complete the form below and click the “submit” button, print and complete the form and fax it to (415) 673-5606; or, as always, feel free to call the office at (415)674-8884.

Case Submission Form


Case Name: vs.

Court: Case Number:

Deadline to Complete Mediation (if any): Court Ordered? Yes No

Trial Date (if any): Mandatory Settlement Conference Date (if any):

Available Dates:


Claimant/Plaintiff:

Name:
Attorney:
Firm Name:
Address:
Street:
City: State:
Country: Zip:
Phone: Fax: Email:

Respondent/Defendant:

Name:
Attorney:
Firm Name:
Address:
Street:
City: State:
Country: Zip:
Phone: Fax: Email:
Carrier:

If more than 2 parties, please either fill out an additional form or provide a proof of service listing the parties and their counsel.