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ADR-107Optional

Attendance Sheet for Court-Program Mediation of Civil Case

California · Judicial Council of California · Effective July 1, 2009

This form is an attendance sheet used during a court-program mediation for a civil case. It asks everyone attending to provide their contact information, such as name, address, phone number, and email.

The court describes it as: People in a court mediation give the mediator and the court their contact information.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

General & info

Information / general use — not tied to one step of a case

This form is used when people are participating in a mediation session that is part of a civil case in court.

Either party may file.

Common questions

What is this form for?
This form is an Attendance Sheet for Court-Program Mediation of Civil Case.
What information do I need to provide?
You need to provide your name, mailing address, phone number, and email address.
Who fills out this form?
The form asks for information from the mediator, the plaintiff/petitioner, and the defendant/respondent.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect July 1, 2009.

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