ADR Mediator Evaluation Form

Download ADR Mediator Evaluation Form

Mediation participants may use this form to provide feedback to the ADR Program Manager on mediator performance, mediation case management, and suggestions for enhancing program services. The information provided will not be used in any personnel matter.

This form may be submitted to the ADR Department via email. Complete the form and email to ADR@workcomp.virginia.gov.

For questions please contact the Commission toll-free at 1-877-664-2566 or by email at Questions@workcomp.virginia.gov.