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20th September 2017

Individual Referral Form

Before the mediation process can start we will require some further information. Please submit the following form and we will be in touch.

Lamb Brooks LLP

Victoria House
39 Winchester Street
Basingstoke
Hampshire
RG21 7EQ


Date of Birth


Date of Marriage

Date of Separation

How many children do you have together?


Date of Birth


Divorce/SeparationArrangements for ChildrenFinance & PropertyParental ResponsibilityOther – please specify

Please advise if there are any issues of domestic violence, mental health or if there is a need for any special arrangements or facilities:

Please confirm if this is an appointment for a MIAM (Mediation Information & Assessment Meeting)

Key Contacts

Ann Davies

Head of Family

Laura Bell

Associate Solicitor

How can we help you?

CONTACT US