Conflict Resolution Center | Request a Mediation

Name *

First

Last

Email *

Phone number: *

Preferred method of contact:

Who are you having conflict with? *

If you said other in previous question, please describe who the conflict is with:

Describe the circumstances or situation around your conflict (What is your conflict? Who is it with? Tell us anything else that we need to know.) *

If you were referred to CRC, who referred you?

If you said "Other" in the previous question, please tell who referred you: