Mediator__________________________   Case_________________________    
Date___________
For each category, 0 means very poor, 10 means very good, and NA means not applicable. The overall rating is not intended to weight the rating of each element equally.
 
Setting up process / opening statement:
 
 
 
 
 
Eliciting important facts:
 
 
 
 
 
Displaying empathy and developing trust:
 
 
 
 
 
Demonstrating even-handedness:
 
 
 
 
 
Assisting in generating options:
 
 
 
 
 
Assisting in generating agreements:
 
 
 
 
 
Dealing with difficult situations, e.g., emotional outbursts, “dirty tricks”:
 
 
 
 
 
Managing interactions, including caucuses:
 
 
 
 
 
Promoting “fair” outcomes:
 
 
 
 
 
Promoting “value-creating” joint-gain outcomes:
 
 
 
 
 
Adhering to ethical standards:
 
 
 
 
 
Overall rating: