4525 Lemmon Ave 200
Dallas, TX 75219
Phone: 214-526-4525
Fax: 214-520-6468
Mediation Services > Mediation Request Form
To request a free consultation regarding your dispute and the potential benefits and cost of mediation, submit the form below.
Name
first last
Title
Company
Address
street line 1
street line 2
, city, state/prov zip
Email
Phone
Fax
Type of Dispute (Required)
Prefered Method of Contact
Phone
Email
   (R)
Attorney Retained?
Yes
No
   (R)
Attorney's Name
Attorney's Phone Number
Attorney's Email

Note: Please do not include any URLs in form.
You can expect a reply to your request within 24 hours.  If you need more immediate attention, call our office at 214-526-4525
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