This document acknowledges that one or both Parties will be accompanied by an attorney, expert, or other advisory representative for the purpose of resolving disputes through mediation administered by Mediation Solutions: Workplace Matters, LLC (“Mediator”).

I understand that the following representative(s) will attend in an advisory capacity and I acknowledge that their communications as part of the voluntary and confidential mediation process. Furthermore, I acknowledge that all participants and representatives must agree to the Terms and Conditions for Mediation (in writing) prior to the session.

This acknowledgement form is intended to foster full transparency and does not constitute legal advice.

Last updated 12.18.25