First name*
Role / Position* OwnerManagerEmployeeOther
Restaurant / Business Name*
Email Address*
Phone Number*
Preferred Contact Method EmailPhone NumberText
Their Name (optional if unknown)
Their Role OwnerManagerEmployeeOther
Are they aware you are seeking mediation? YesNoNot Sure
Type of Dispute Ownership / PartnershipFranchisor / FranchiseeEmployee or Management ConflictVendor / SupplierLease / LandlordFamily Business DynamicsFranchisor / FranchiseeOther
How long has this issue been happening? Less than a week1–4 weeks1–3 months3+ months
Has any legal action been taken? YesNo
Describe any legal steps taken
Preferred Mediation Format In-personOnline / Virtual
Preferred Time Window MorningAfternoonEvening
Preferred Session Day(s) MondayTuesdayWednesdayThursdayFriday
Upload Relevant Documents (optional)
All information submitted is confidential and used only to prepare for your mediation session. This form does not create an attorney–client relationship. By submitting this form, you confirm the information provided is accurate to the best of your knowledge.
I understand and agree to the confidentiality terms.
Peter will review your information and contact you to confirm your session date.
