Acknowledgment of Confidentiality Mediation Session

Orange County Superior Court · Locally Approved Forms

Verified current as of July 16, 2026

This form is used to confirm that people participating in court-ordered mediation understand that what they discuss during mediation sessions must be kept private and cannot be used as evidence in court. Anyone involved in a court case who is required to attend mediation—such as divorcing spouses, parties in a custody dispute, or people in a civil lawsuit—would need to sign this form.