This form is used to input your information into our database for referral to cases for service. If selected, ADRMediator, Inc/Family. will contact you to schedule a preliminary interview for final acceptance as a panel member to ADRMediator, Inc/Family. By your digital signature, you accept our terms and conditions; you authorize ADRMediator to market and promote you as a Mediator to prospective clients. You are not obligated to accept any Mediation appointment.