Referral Form – Public Sector


The Family Mediation & Counselling Services (FMACS) provide specialist support to local authority, Social Services and Family & Children’s Teams. Our Family Mediation Consultants (FMC) are specially trained family mediators and are members of the College of Mediators and or the Family Mediation Council.  Each have considerable experience of working with families in dispute following separation or divorce.  We also have specially trained DCC (Direct Consultation with Children) mediators and counsellors where it beneficial to include children in the mediation process.


To make a referral enquiry, please complete the online form (below) or download a PDF or Word version for completion offline. Complete and submit below or email it to Or if you would prefer, you can telephone one of our Mediation Advisors on 0330 113 0005 (local rates apply) to discuss the individual case.  Your Advisor will talk to you about how best we can help.  They will also be able to advise you about how long mediation may take to reach a satisfactory outcome.  This can vary depending on the complexities of the case and the level of conflict.


Once you are ready to confirm a referral, you must complete a Case Referral Form and send it together with a purchase order to  Once we receive your request we will assign a Family Mediation Consultant (FMC), who will contact you to discuss the process.

Your FMC will then send an information pack to each person involved in the mediation process.  Following this, they will contact them directly and arrange an individual Mediation Assessment Meeting and the first Joint Mediation Meeting (JMM).

Throughout the process, your FMC will provide updates on the progress of the case.  This will include general indicators as to the progress in reaching agreements but will not include any personal details relating to any discussions that may have taken place.  As the mediation process is confidential, it is no possible to provide details unless both parties, agree to it.  Updates will also include notifications of meeting dates and times and their completion thereof.

Your FMC will also contact you should they feel additional JMMs would benefit the overall outcome.


The FMC will work with both parties to help them find a lasting solution.  Once this is achieved, the FMC will draw-up a Memorandum of Understanding (See Memorandum of Understanding) for each party.  They will also ask if they wish it to be shared with their social worker or family worker.  If they agree, a copy will be sent to the referrer.  The Memorandum of Understanding is a legally privileged document and therefore cannot be used for legal or court purposes.

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