• Please complete this form to participate in mediation offered by the Aboriginal Mediation Service if your matter is assessed as suitable. Prior to completing this form, please read the following:

    • What is Mediation/Conflict? 

    • Mediation/Conflict (resolution) is a voluntary process where people come together to talk/yarn about a conflict that has raised between two or more people and agree to work towards an outcome where everyone can accept.

      Mediation is guided by qualified mediators, who act as neutral third parties. They support the conversation, help participants explore the issues, and identify possible solutions.

      While the mediator facilitates the process, it is the participants who decide on the outcomes and take responsibility for making their agreements work.

    • How it works 

    • Mediation/Conflict (resolution) is a voluntary process where people come
      together to talk/yarn about a conflict that has raised between two or more people
      and agree to work towards an outcome where everyone can accept.

      Mediation is guided by qualified mediators, who act as neutral third parties. They
      support the conversation, help participants explore the issues, and identify
      possible solutions.

      While the mediator facilitates the process, it is the participants who decide on the
      outcomes and take responsibility for making their agreements work.

    • Costs 

    • The cost of the Mediation with Aboriginal Mediation Service is free for participants.

    • For further information or if you need help, contact the Aboriginal Mediation Service on 61 8 9264 6176 or 1800 045 577 (free call).

  • Where did you hear about AMS?*
  • Do you identify as Aboriginal or Torres Strait Islander?*
  • Is this your first time accessing the Aboriginal Mediation Service?*
  • Are you initiating the mediation for yourself to attend or on behalf of someone else?*

  • Would you like to be kept up-to-date with this referral?*
    • Your contact details 
    •  -
  • Have you advised the other parties in conflict that you are lodging a referral with AMS?*
  • How many people/parties are involved and would need to be invited?*
    • Party A details 
    •  -
    • Party A - Aboriginal or Torres Strait Islander?
    • Party B details 
    •  -
    • Party B - Aboriginal or Torres Strait Islander?
    • Party C details 
    •  -
    • Party C - Aboriginal or Torres Strait Islander?
    • Party D details 
    •  -
    • Party D - Aboriginal or Torres Strait Islander?

  • Details of the Dispute

    Please complete as much details as you can about the dispute to help support the Case manager to direct you to the right person.
  • Location of the Dispute*
  • The Dispute is about:*

  • If you have any issues lodging this referral form, you can call 1800 045 577 (free call) or 08 9264 6176 to speak to a staff member that can assist you.

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