Palaver Hut Mediation Form

First Name *
Last Name *
Email *
Phone Phone * - ### - ### ####
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Names and Contacts of Parties Involved (if applicable) 1 name per line
Narratives: Please write details of your story/ matter below to be mediated. Someone will get back to you within 48hrs after your submission. *
Supporting / additional documents can be attached from here

Attach Files
CONSENT: By submitting this form, you have consented that the content is correct to the best of your knowledge and ability, and Palaver Hut is not liable for the information and content provided and hereby given Palaver Hut management and team to use the information for the purpose of mediation between you and your party / ies involved.
You are also consenting to Palaver Hut to use it’s informed judgement to either store, preserve or destroy any information provided for mediation of the matter. *

CONSENT: By submitting this form, you have consented that the content is correct to the best of your knowledge and ability, and Palaver Hut is not liable for the information and content provided and hereby given Palaver Hut management and team to use the information for the purpose of mediation between you and your party / ies involved.
You are also consenting to Palaver Hut to use it’s informed judgement to either store, preserve or destroy any information provided for mediation of the matter. By submiting this form, you agree with our privacy policy & Terms and Conditions