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Family Mediation Intake Form

The information that you provide to us in this document is intended to be kept confidential between you and Riverdale Mediation Ltd. as it is provided as part of a confidential dispute resolution process. No party may seek disclosure of what the other wrote on their intake forms and we will keep your information confidential.

 

There are however exceptions to confidentiality in family dispute resolution including our duty to report to a Children’s Aid Society if a child is at risk of harm; our duty to warn a person if there is a threat to their safety; or if a judge orders us to disclose information to the court.

 

By completing this intake form you agree to these terms. Please ask us if you have any questions.

 

NOTE: Each party is required to complete and submit their own form. 

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