20th September 2017

Individual Referral Form

If you would like to proceed with the mediation process please complete the below form in as much detail as possible and we will be in touch with both you and your partner / ex-partner with a meeting date.


If you would like to discuss this with our Mediation team first or obtain further information please call Julia McGuigan on 01256 305596.

Lamb Brooks LLP

Victoria House
39 Winchester Street
RG21 7EQ

Date of Birth

Solicitor Details

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

Laura Bell

Associate Solicitor

How can we help you?