Mediation Questionnaire – Ohio Court

The Mediation Questionnaire from the Cleveland Municipal Court Housing Division is designed to gather feedback on participants’ experiences with the mediation process. The Mediation Questionnaire aims to assess the neutrality of the mediator, the opportunity for open discussion, the resolution of conflicts, and the overall effectiveness of the mediation program. Participants are asked to respond to several yes/no questions, including whether the mediator remained neutral, if they had the chance to discuss important issues, and if the conflict was resolved or if progress was made in resolving it. Additionally, the Mediation Questionnaire inquires about previous usage of the mediation program and whether participants would recommend it to others. There is also a section for further comments and optional personal information. Responses are confidential and will be reviewed by the Housing Court Mediation Coordinator.

The Mediation Questionnaire is a tool used by the Cleveland Municipal Court Housing Division to collect your feedback on the mediation process. Follow these steps to complete the form:

• Read Each Question Carefully: Take your time to understand each question before answering. Your honest feedback is crucial for improving the mediation program.
• Answer Each Question
  • Question 1: “The mediator remained neutral.”
    • Check Yes if you felt the mediator was impartial.
    • Check No if you felt the mediator showed bias.
  • Question 2: “I had an opportunity to talk openly about the issues that were important to me.”
    • Check Yes if you were able to express your concerns freely.
    • Check No if you felt restricted in discussing your issues.
  • Question 3: “Our conflict was resolved.”
    • Check Yes if the mediation led to a resolution.
    • Check No if the conflict remains unresolved.
  • Question 4 (Only if you answered No to Question 3): “Do you have a better understanding of the conflict?”
    • Check Yes if the mediation helped you understand the conflict better.
    • Check No if it did not enhance your understanding.
  • Question 5: “Was progress made in resolving the dispute?”
    • Check Yes if there was any progress toward resolving the dispute.
    • Check No if no progress was made.
  • Question 6: “Have you ever used the housing mediation program before?”
    • Check Yes if you have previously participated in the program.
    • Check No if this was your first time.
  • Question 7: “Would you recommend the mediation program to someone with a conflict?”
    • Check Yes if you would recommend the program to others.
    • Check No if you would not recommend it.
• Provide Additional Comments
  • If you answered No to Question 7, please explain why in the space provided.
  • Feel free to use the back of the sheet for any further comments or feedback you have about the mediation program.
• Optional Information
  • You may include your name and the date if you wish, but this is not mandatory.
• Submission
• Once you have completed the questionnaire, place it in the provided envelope.
• Your responses will be kept confidential and reviewed by the Housing Court Mediation Coordinator.