Dependency Mediation Program

San Francisco Superior Court · All Local Forms

Verified current as of July 19, 2026

This form is used to request help resolving disagreements in child dependency cases—situations where a child has been removed from their parents' care due to abuse or neglect concerns. Parents, guardians, social workers, or other parties involved in the case would use this form to ask for a mediator to help them reach agreements about the child's care, visitation, or other issues without going to court.