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Mediation Case Information Form

Use a MEDIATION CASE INFORMATION FORM template to make your document workflow more streamlined.

What the mediation information form does

The Mediation Case Information Form organizes information needed to administer a mediation case and document the participants’ responses, acknowledgments, and signatures. It is not a universal court filing or a substitute for state-specific legal advice. In signNow, upload the form, review automatically detected fillable fields, assign each field to the correct mediator, party, or representative, and send the document for completion. Participants review the record and sign electronically when authorized. SignNow then preserves the completed document and audit trail, supporting attribution, timestamps, and later authorized review under applicable U.S. law.

Who uses the mediation information form

Mediators and administrators

Mediators and mediation administrators use the form to collect party information, dispute details, scheduling data, and acknowledgments before or during a U.S. mediation process. They can send a prepared document through signNow, assign fields to named participants, and preserve the completed record with its audit trail for authorized case review.

Organizations managing disputes

Law firms, community dispute programs, insurers, employers, and healthcare organizations may use the form when a dispute requires organized participant information and documented consent. The appropriate workflow depends on the case, state law, confidentiality obligations, and whether the record contains regulated personal or health information.

How the mediation form works

The signNow workflow turns the Mediation Case Information Form into a controlled record from upload through authorized archival.

  • Upload: Upload the current form PDF.
  • Review fields: Auto-detect and verify fillable fields.
  • Assign: Assign fields to named participants.
  • Complete: Send, sign, and preserve evidence.

Complete the mediation form online

Use signNow to prepare the Mediation Case Information Form, route assigned fields, capture signatures, and preserve completion evidence.

  • Upload form:

     Upload the current form PDF to signNow.

  • Assign fields:

     Review detected fields and assign recipients.

  • Send document:

     Send the form to mediation participants.

  • Complete and store:

     Collect signatures and download the record.
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Review the signNow audit trail

The audit trail shows how the Mediation Case Information Form moved from assigned fields to signed, exportable case evidence.

01

Authenticate signer:

 Confirm the signer through the assigned recipient workflow.
02

Record timestamp:

 Capture the signing event’s date and time.
03

Track actions:

 Log each field completion and document action.
04

Seal history:

 Preserve the completed document history.
05

Export evidence:

 Download the audit trail with the signed PDF.
06

Archive record:

 Store both files under the case record.

Connect mediation records to business systems

Route completed Mediation Case Information Forms into named CRM, ERP, cloud storage, and project systems while preserving the signed document and completion evidence.

Salesforce
Procore
Zapier
Microsoft Teams
Hub spot
Box
Microsoft

Record-keeping practices for mediation forms

Retain the signed form, evidence of consent, and audit history according to the record’s actual legal and business context.

Apply the correct retention rule

Assign responsibility for the signed Mediation Case Information Form, completed certificate, and related communications. For records containing protected health information, retain documentation for 6 years from creation or the last effective date under 45 CFR §164.530(j), unless a longer state rule applies.

Export the audit trail

After each mediation case closes, export the completed PDF and signNow audit trail together. Preserve signer identity, timestamps, access events, and document history so authorized reviewers can evaluate how the record was completed without relying on an active account.

Archive records securely

Store the signed form and audit trail in an access-controlled repository with encryption at rest, restricted downloads, and documented retention labels. Separate mediation records from drafts and limit access to assigned mediators, case administrators, and authorized legal reviewers.

Document every disposition

Before removing a record, check litigation holds, open disputes, contractual obligations, and applicable state requirements. A deletion schedule should pause when a preservation duty applies, and every disposition should record the date, approver, record class, and reason.

Privacy pitfalls in mediation records

  • Including unnecessary medical, financial, or family details in the signed form can expose personal information to recipients who only need mediation logistics.
  • Failing to capture a signer’s consent to electronic records can weaken evidence that the party intended to complete the Mediation Case Information Form electronically.
  • Sending the form to every participant instead of assigned recipients can disclose allegations, contact details, or settlement information beyond the mediation team.
  • Using a shared account obscures which mediator or administrator entered information, weakening attribution and complicating later review of the completed record.

Retention periods for mediation records

Choose the retention period from the record’s actual regulatory context; the Mediation Case Information Form alone does not create one universal deadline.

01

Six years for HIPAA records

Apply 45 CFR §164.530(j) when the mediation record contains HIPAA-covered health information; retain it for six years from creation or last effective date.
02

Three years for tax records

Retain federal tax-related mediation records for three years from filing under IRC §6501(a), unless a six-year or indefinite rule applies.
03

Three years after hire

Retain employment-related records for three years after hire or one year after termination, whichever is later, under 8 CFR §274a.2(b)(2)(i)(A).
04

Three years for payroll

Retain covered payroll records for three years under 29 CFR §516.5 when the mediation file forms part of the employer’s payroll documentation.
05

Six years for broker records

Retain covered broker-dealer books and records for six years under 17 CFR §240.17a-4 when the mediation file belongs to that regulated record set.

Documents outside electronic signing

Notarization

 May require notarization

Wills and codicils

 Excluded under ESIGN

Court orders

 Not a court filing

Family law documents

 State rules may apply

Troubleshooting mediation form workflows

Resolve field, consent, authentication, plan, and retention issues before the completed mediation record is distributed or archived.

Upload the current Mediation Case Information Form PDF and confirm that signNow’s detected fields match the document before sending. Add or correct text, date, initials, and signature fields manually when auto-detection misses a field or assigns it to the wrong participant.

Use signNow’s recipient roles and field assignments to distinguish the mediator, disputing parties, representatives, and witnesses. Review each recipient’s required fields before sending; an unassigned required field can prevent completion or place information with the wrong signer.

Business includes legally binding eSignatures, templates, and audit trails at $8 per user per month when billed annually. The Business Premium plan adds bulk send and costs $15 per user per month annually; confirm plan limits before sending repeated case packets.

For consumer-facing electronic records, provide the ESIGN disclosure covering paper access, electronic access, and withdrawal procedures under 15 U.S.C. §7001(c). SignNow can document the signing event, but the organization remains responsible for delivering the required disclosure.

Use stronger authentication when the form contains sensitive dispute or health information. SignNow supports two-factor authentication and SMS-based verification options; HIPAA workflows require a business associate agreement and appropriate organizational safeguards.

After completion, download the signed form and audit trail from signNow and place both in the approved case repository. For HIPAA-covered records, retain documentation for 6 years under 45 CFR §164.530(j), subject to longer state requirements.

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