Refer a Case (beta)

Complete this form to refer your case to us.
Please only provide client details if they are expecting a call from Calm Mediation. You can leave their details blank if you want to start the process right now.

We take client privacy seriously, all personal information provided is stored in a secure database and deleted in line with our privacy policy (linked).


If you are already familiar with how we work, it is easy to refer a case to us. Simply complete the form below, starting with your own contact details.

If you have any questions at all please don’t hesitate to contact us.

We will be in touch within 3 working days to confirm it’s receipt.

Security: As you can see we use the more secure https webpage. This form works directly with our case management system and does not use unnecessary third parties.

Principal Reason for Referral:

Dispute Length:

Special Concern:

My First Name:

How I heard about Calm Mediaiton:


I have the consent of the people whose information I share:

It is very important that you only provide other’s contact details if they are expecting our call. You can start the referral with only your details if you need more time to speak to these individuals.

I am a client on this case:

C2 First Name:

C2 Last Name:

C2 Email:

C2 Phone:


C3 First Name:

C3 Last Name:

C3 Email:

C3 Phone:

If there are more than two clients, we will get their information once we are speaking on the phone.