DCAP Petitioner’s Survey From 1 (lowest) to 5 (highest), what was your level of satisfaction with:From 1 (lowest) to 5 (highest), what was your level of satisfaction with: 12345The MediatorMediation Facilities (If applicable)Lunch (If applicable)Mediation PersonnelPlease add any additional comments you would like us to know:Voluntary Demographic PortionThe following questions are voluntary and will only be used for statistical purposes.What is your age?What is your ethnic origin?Were any children the subject of this meditation?Case Name/Number(Required)Surveys will remain anonymous. However, DCAP requires a case name or number to be listed so we can ensure the survey is entered into the correct file.
