The Mediation Center of the Coastal Empire

A 501c 3 Non-Profit Organization

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Mediation Practicum Form


You are one step closer to completing your practicum requirements and registering with the Georgia Office of Dispute Resolution as a neutral. Please complete the form below. Submitting this information confirms you observed the entire mediation. This form must be completed within five business days from the date of your observation. Otherwise, the observation will not count toward your practicum hours.

Once our team receives the form, we will send you and the mediator a filled-out GODR Observation Form requesting signatures. Once signed, you will receive a copy from Adobe Sign. Please save this for your records as the signed form is needed to  1) keep track of your practicum hours and 2) the form will need to be submitted to the GODR during regitration.

The Mediation Center provides opportunities for individuals to complete their practicum requirements.  The individual completing the practicum requirements is responsible for completing the requirements by the deadline, submitting the form below, and maintaining signed forms to submit for registration. If you have questions regarding your practicum, for civil, please contact Pam Manning at pmanning@mediationsavannah.com; for domestic, please contact Sasha Fountain at sfountain@mediationsavannah.com or Lee Robbins at lrobbins@mediationsavannah.com.


Mediation Practicum Form

Please complete this form in order to confirm your observation. Once complete, our team will send out the GODR Observation/Co-mediation Form for signatures to you and the mediator.

Is this your first, second, third, forth, or fifth observation?
Please know that participants must complete their practicum by observing case types directly associated with their recently completed training. For example: civil training requires you to observe all civil cases. Domestic observations will not count to your practicum hours.
MM slash DD slash YYYY
Form must be submitted within 5 business days of mediation in order for the observation to count towards practicum hours.
Please choose the appropriate result. We apologize in advance, unfortunately, no shows cannot be counted toward your practicum hours.

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The Mediation Center
7505 Waters Avenue
Suite C11
Savannah, GA 31406

912-354-6686
info@mediationsavannah.com

Family Law Resource Center
912-354-6686
flrc@mediationsavannah.com

Youth Programs
912-999-2110
youth@mediationsavannah.com

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The Mediation Center of the Coastal Empire
7505 Waters Avenue
Suite C11
Savannah, GA 31406

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