Form

Referred by

First name*

Last name*

Firm/Company*

Telephone

Email*

Client name (if different from Referrer)

Second party

Second party name

Second party last name

Firm/Company

Second party telephone

Second party email

Client name (if different from the second party name)

Third party

Third party name

Firm/Company

Third party email

Telephone

Client name (if different from Third party name)

Fourth party

Fourth party name

Firm/company

Fourth party email

Telephone

Client name (if different from the fourth party name)

Have all the parties agreed to the Arbitration?

Yes

Would you like CEDR to contact the other parties to propose Arbitration?

Yes

General information

Nature of dispute

Other (if not listed)

Are the parties working to a timetable or deadline?

Special requirements of mediator (sector knowledge, profession, etc.)

A dispute resolution adviser will contact you shortly. Would you prefer this to be by *

Phone

Please carefully check all information, especially your own email address, that you have supplied on this form. You may also wish to print a copy for your records before clicking the Submit button. All information supplied is transmitted via our secure server and is encrypted for maximum security.

For further information about this service, please contact CEDR's Dispute Resolution team on +44 (0)20 7536 6060 or email adr@cedr.com.