Petition for Mediation Services

Please complete the form below.  Note that fields marked with an asterisk (*) are required.  Once the form has been submitted, you will receive an e-mail response with a copy of all data submitted.  If you have any questions while completing the form, contact Janet Johnson 651-649-5426.


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* If first contract, enter NA.

PETITIONER MUST SEND A COPY OF THIS PETITION TO THE OTHER PARTY(S).
IF THIS IS A JOINT PETITION, IT WILL NOT BE PROCESSED BY THE BUREAU OF MEDIATION SERVICES UNTIL WE RECEIVE WRITTEN CONFIRMATION FROM THE NON-SUBMITTING PARTY(S). WRITTEN CONFIRMATION CAN BE SENT FROM THE OTHER PARTY(S) BY FORWARDING THIS E-MAIL TO JANET.JOHNSON@STATE.MN.US.
QUESTIONS: JANET JOHNSON, 651-649-5426
Once the Petition has been submitted online, do NOT mail, fax or e-mail the original.

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