Pre-Session Questionnaire

Brief questionnaire to assist the mediator(s) in preparing for the facilitated session and the participants to reflect on what they'd like to accomplish during their session.

Name*
First Last
Email*
My top three issues to resolve in this session are:*
These issues are affecting me in the following ways:*
When you and your coworker aren't working together productively, who around you is impacted, other than yourselves?*
How is the conflict affecting the business (organizational results, productivity, desired outcomes, morale)?*
What changes can you make to help the situation?
What changes do you hope to see your coworker(s) make?
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