"Mediation Agreement" - Oklahoma

Mediation Agreement is a legal document that was released by the Oklahoma Workers Compensation Commission - a government authority operating within Oklahoma.

Form Details:

  • Released on December 18, 2014;
  • The latest edition currently provided by the Oklahoma Workers Compensation Commission;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Oklahoma Workers Compensation Commission.

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OKLAHOMA WORKERS' COMPENSATION COMMISSION MEDIATION SYSTEM
Date: _______________________________ Workers’ Compensation Commission File
Number, (if any) _______________________
INITIATING PARTY:
RESPONDING PARTY:
____________________________________
______________________________________
____________________________________
______________________________________
MEDIATION AGREEMENT
We, the disputing parties, certify that this agreement shall constitute a mutually
acceptable solution and shall abide by the following terms and conditions.
WE AGREE THAT OUR OBLIGATIONS ARE AS FOLLOWS:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
WE FURTHER AGREE that in the event any disputes arise as to the terms of the
agreement reached, the mediator shall be the sole, final arbiter of those disputes.
We have read and understand this Agreement and agree to abide by its terms and conditions.
INITIATING PARTY:
RESPONDING PARTY:
____________________________________
______________________________________
____________________________________
______________________________________
Initiating Party’s Attorney, If Any:
Responding Party’s Attorney, If Any:
____________________________________
______________________________________
____________________________________
______________________________________
Date: ______________________________
Date: _________________________________
____________________________________
Mediator
Updated 12-18-14
OKLAHOMA WORKERS' COMPENSATION COMMISSION MEDIATION SYSTEM
Date: _______________________________ Workers’ Compensation Commission File
Number, (if any) _______________________
INITIATING PARTY:
RESPONDING PARTY:
____________________________________
______________________________________
____________________________________
______________________________________
MEDIATION AGREEMENT
We, the disputing parties, certify that this agreement shall constitute a mutually
acceptable solution and shall abide by the following terms and conditions.
WE AGREE THAT OUR OBLIGATIONS ARE AS FOLLOWS:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
WE FURTHER AGREE that in the event any disputes arise as to the terms of the
agreement reached, the mediator shall be the sole, final arbiter of those disputes.
We have read and understand this Agreement and agree to abide by its terms and conditions.
INITIATING PARTY:
RESPONDING PARTY:
____________________________________
______________________________________
____________________________________
______________________________________
Initiating Party’s Attorney, If Any:
Responding Party’s Attorney, If Any:
____________________________________
______________________________________
____________________________________
______________________________________
Date: ______________________________
Date: _________________________________
____________________________________
Mediator
Updated 12-18-14