:: IVAMS Arbitration Mediation Services

Hearing Requests

To print out & mail in a Hearing Request form, download it by clicking here.

BASIC INFORMATION

Name of Case (required):		Date:
Requesting Party:		Contact Person:
Date of Loss:

PLAINTIFF/PETITIONER

Name(s) (required):
Number of People Attending Hearing (Including Representative): (required)
Attorney:		Firm:
Address:
City:
State:		Zip:
Telephone (required):		Fax:
Email (required):

DEFENDANT/RESPONDENT

Name(s) (required):
Number of People Attending Hearing (Including Representative): (required)
Attorney:		Firm:
Address:
City:
State:		Zip:
Telephone (required):		Fax:
Email:
Insurance Co., If Applicable, Including Claim No:
Insurance Co. Address:
City:
State:		Zip:
Adjustor:

TYPE OF SERVICE REQUESTED

Mediation

Binding Arbitration

Non-Binding Arbitration

Other (Please Explain)

Type Of Case (required)
	First Attorney Choice:	First Judge Choice:

	Second Attorney Choice:	Second Judge Choice:

	No Preference-Please submit a Neutral Suitable for my case

CASE PENDING IN:
Court: Judge:

Court Case Number:

Select Location

Preparation/ Research Time

Estimated Hearing Time

Total Estimated Time

ADDITIONAL COMMENTS / ADDITIONAL PARTIES

I have read IVAMS arrangement and fees policy and agree to the terms.
>>> View arrangements and fees.

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Disclaimer:
Please be advised that the contents of this web site and any other statements contained
herein are for informational purposes only and are not intended to be represented as legal advice in any way.