Please provide feedback on your mediation experience. Your response will be treated as confidential. 91ÖÆƬ³§ Case Reference No. (if known) Your name Dispute resolution option Mediation Conciliation Arbitration Name of mediator/conciliator/arbitrator Date/s of mediation/conciliation/arbitration Your role in the dispute Franchisor Franchisee Please rate your satisfaction with your mediator/conciliator/arbitrator Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied Was your dispute resolved? Resolved Partially resolved Unresolved Would you recommend this mediator/conciliator/arbitrator? Yes No Would you like to provide any comments about the process or your mediator/conciliator/arbitrator?