Is Mediation right for you?

1. Full Name*

1. Full Name*

2. Phone Number*

2. Phone Number*

3. Email Address*

3. Email Address*

4. Postal Code and Country*

4. Postal Code and Country*

5. Do you have minor children or adult children who are financially dependent on you?*

5. Do you have minor children or adult children who are financially dependent on you?*

6. Do you have shared assets?*

6. Do you have shared assets?*

6. (Select all that apply)

7. Case Status (Current stage of the process):*

7. Case Status (Current stage of the process):*

8. What is your initial level of agreement?*

8. What is your initial level of agreement?*

9. Brief summary of the reason for contact:

9. Brief summary of the reason for contact:

10. I have read and I accept the terms and conditions and the data protection policy.*

10. I have read and I accept the terms and conditions and the data protection policy.*

10. Terms and conditions of the mediation prior assessment

The completion of this questionnaire is for the sole purpose of conducting a preliminary assessment of the potential suitability of your case for a strategic mediation process within the Divorcio Consciente® Method.

Nature of the information provided: The information provided in this form: Is for informational and guiding purposes only. Does not constitute legal advice or a legal opinion. Does not create any professional or contractual relationship. The mediator does not act as an attorney nor offers legal defense services, regulatory interpretation or recommendations on legal rights or obligations

Purpose of the questionnaire. The data collected will be used only to: Evaluate if the case may be suitable for mediation. Determine if it is appropriate to offer an information session. Contact the person interested in relation to this request. It will not be used for other commercial purposes nor will it be shared with third parties.

Confidentiality All information provided will be treated with absolute confidentiality in accordance with the principles of mediation and current data protection regulations.

Personal data protection. Data controller: María José Bonilla Garriga. — Divorcio Consciente® Purpose: Management of mediation prior assessment requests. Legal basis: Consent of the interested party. Rights: You may exercise your rights of access, rectification, erasure, limitation and opposition by sending a request to: 📧 info@divorcioconsciente.es Data will be kept only for the time necessary to manage the request.

Absence of obligation to hire. The completion of this form: Does not imply an obligation to initiate mediation. Does not involve any financial commitment. Does not guarantee the acceptance of the case.

Acceptance. By submitting this questionnaire, the person declares that the information provided is truthful, that they understand the limited scope of this prior assessment, and that they expressly accept these terms and conditions.

If you prefer to speak directly, we can have a brief call to clarify your doubts about the method and confirm the feasibility of your process.

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