Mediation Consultation Form Your Affiliation Faculty Supervisor Staff Student Employee Not Affiliated with U-M I Am Filling Out This Form to: Request mediation for myself Recommend mediation to other individuals Learn more about mediation Name * Uniqname or UM ID * We'll be scheduling the consultation via zoom or phone call. If you prefer we contact you at a non-work email address or phone number please feel free to provide that. Email Please schedule my consultation via: Zoom Phone Phone Number Would you like a calendar invitation sent for your consultation? Yes No If you would like the calendar invite sent to a different email address than what you have provided above, please list it here. Person(s) Involved Please enter the name(s) of individuals and/or departments, etc., involved in the situation. Please include uniqname(s) and/or UM ID, if available. Description of Concern * Please provide a brief description of the issue of concern. 0 of 1500 max characters Submit If you are human, leave this field blank.
