Sample Peer Mediation Program Documents

All of these documents are samples that could be used in a peer mediation program. They include documents for mediators, students participating in mediation, and for staff. Other documents that could be created may include a form to request mediation, a document that details appropriate conflicts for mediation, and a document that could be sent home to parents detailing the program.

This document serves as an agreement for mediators that they will follow specific guidelines and that they will respect confidentiality throughout the peer mediation process.

This document is an example of an agreement that participants in the mediation process would sign. This document can serve useful for confidentiality purposes or to guarantee that a student participates in the process, if disciplinary action is the other consequence.

This document is crucial for every peer mediation program because it documents what students received mediation. This can be useful for tracking, data collection, and attendance purposes.

This document is an excellent tool for mediators to utilize because it helps foster the mediation process by using these key phrases to begin and facilitate discussion.

This document is an example of some sample ground rules for the mediation process. It is important that students learn to respect these rules and they are explained clearly in each mediation process.

This letter is an example of a letter that can be sent to teachers and staff within the school to explain what the program is and many of the logistics of the program.