ATTORNEY NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

STATE BAR NO.:

STATE:

ZIP CODE:

E-MAIL ADDRESS:

MEDIATION DISCLOSURE NOTIFICATION  
AND ACKNOWLEDGMENT 

ADR-200

To promote communication in mediation, California law generally makes mediation a confidential 
process. California's mediation confidentiality laws are laid out in sections 703.5 and 1115 to 1129, 
inclusive, of the Evidence Code. Those laws establish the confidentiality of mediation and limit the 
disclosure, admissibility, and a court's consideration of communications, writings, and conduct in 
connection with a mediation. In general, those laws mean the following: 

•  All communications, negotiations, or settlement offers in the course of a mediation must 

remain confidential. 

•  Statements made and writings prepared in connection with a mediation are not admissible or 

subject to discovery or compelled disclosure in noncriminal proceedings. 

•  A mediator's report, opinion, recommendation, or finding about what occurred in a mediation 

may not be submitted to or considered by a court or another adjudicative body. 

•  A mediator cannot testify in any subsequent civil proceeding about any communication or 

conduct occurring at, or in connection with, a mediation. 

his means that all communications between you and your attorney made in preparation for a 
mediation, or during a mediation, are confidential and cannot be disclosed or used (except in 
extremely limited circumstances), even if you later decide to sue your attorney for malpractice 
because of something that happens during the mediation. 

, _____________________________ [Name of Client], understand that, unless all participants 
agree otherwise, no oral or written communication made during a mediation, or in preparation for a 
mediation, including communications between me and my attorney, can be used as evidence in any 
subsequent noncriminal legal action including an action against my attorney for malpractice or an 
ethical violation. 

OTE: This disclosure and signed acknowledgment does not limit your attorney's potential liability to 

you for professional malpractice, or prevent you from (1) reporting any professional misconduct by 
your attorney to the State Bar of California, or (2) cooperating with any disciplinary investigation or 
criminal prosecution of your attorney. 

(TYPE OR PRINT CLIENT NAME)

(SIGNATURE OF CLIENT)

  

 

 

 

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Date:

Date:

(TYPE OR PRINT ATTORNEY NAME)

(SIGNATURE OF ATTORNEY)

Form Approved for Optional Use 
Judicial Council of California 
ADR-200 [New January 1, 2020]

MEDIATION DISCLOSURE NOTIFICATION AND ACKNOWLEDGEMENT

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Evidence Code, § 1129 
www.courts.ca.gov