Fill out the information below ONCE and click the SUBMIT button at the bottom of this form. Your information is confidential and will not be shared without your permission. This form is used for mediation service requests, excluding the Eviction Resolution Pilot Program. Be sure to mark the appropriate box indicating the type of conflict you seek assistance for.

PLEASE ONLY SUBMIT THIS FORM ONCE, SUBMITTING THIS FORM MULTIPLE TIMES DELAYS OUR RESPONSE TIME.

Mediation Request Form

If you are having trouble submitting this form, please email drcinfo@kcdrc.org

THANK YOU