MED-200 Request for Court-Sponsored CINA Mediation 6-15 Mediation Forms 2026

1. Click ‘Get Form’ to open the MED-200 form in our editor.
2. Begin by entering the case number at the top of the form. This is essential for tracking your request.
3. In section 1, indicate your request for a referral for CINA Mediation by checking the appropriate box.
4. For section 2, select your role from the list provided (e.g., OCS Worker, Mother, etc.). This helps clarify your position in the mediation process.
5. In section 3, confirm whether you have consulted with other legal parties regarding this referral. While not required, it’s beneficial for transparency.
6. Specify available dates and times for mediation in section 4. Ensure all participants can attend on the chosen date.
7. List participants in section 5 along with their relationships and contact information. If more space is needed, attach an additional sheet as indicated.
8. In section 6, outline key areas or issues that should be addressed during mediation to guide discussions effectively.
9. Finally, sign and date the form at the bottom before submitting it to ensure your request is valid.

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