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FA-5004V

Request for Mediation Instructions

Wisconsin · Wisconsin Court System · Effective May 4, 2017

This form is used to ask the court to order both parties to attend mediation when they disagree about legal custody or where a child should live. It provides instructions for people representing themselves in this process.

The court describes it as: Instructions for pro se on mediation process.

Open the official PDFfrom Wisconsin Court System

Where this fits in a case

Motions

Stage: Motions

This form is used when parties are in a disagreement about a child's legal custody or physical living arrangements and want the court to order mediation.

Either party may file.

Common questions

What is this form for?
This form is used to ask the court to order mediation when you and the other party disagree about legal custody or physical placement of a child.
What do I need to do after filling this out?
You must complete the Request for Court Ordered Mediation (FA-4134V) form and mail or take it to the court.
Does the court give legal advice?
No, the form notes that court staff cannot give legal advice.

Revision history

No changes recorded since we started tracking this form on October 10, 2026. The current version took effect May 4, 2017.

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