Victim-Offender Mediation Program Survey

Contact person:

Ms. ____________________________________________________
Mr. ____________________________________________________
Title ____________________________________________________
Name of VOM program _____________________________________
Name of agency (if different from program) _______________________
Address _________________________________________________
Telephone/Fax ____________________________________________
E-mail __________________________________________________
Internet _________________________________________________

1. Type of agency

2. How many cases were referred to the program during the most recent year?

3. At what point(s) in the justice process is mediation done?

4. What year did the program begin operation or when is it projected to begin?
    _________

5. What kinds of referrals do you accept:

6. In addition to victim-offender mediation, the Center gets many requests for information on institutions performing other forms of mediation and dialogue. Please check each box that indicates a form of mediation that your program performs.

7. Does your program consider cases involving sexual assault?

8. Does your program consider cases involving sexual abuse?

9. Many programs perform mediation processes in which the participants do not come face-to-face. In your restorative justice process, is the participation face-to-face direct) or by some other means (indirect)?

Approximately what percentage of your mediation processes are performed:
Directly? ________ Indirectly? ________

How are indirect mediations performed?

Please return the survey to:

Center for Restorative Justice & Peacemaking
University of Minnesota School of Social Work
1404 Gortner Avenue, 105 Peters Hall
St Paul, MN 55108-6160
Fax: 612-625-8224