Intake Information Form Intake Information Form Please submit the form below so that we may complete a conflicts check and determine our availability to accommodate your request. Please share the name, telephone number and email address for the preferred point of contact so we may direct our follow-up appropriately. Main point of contact Nature of request: ArbitratorMediatorReferee/Special MasterConsultant (trials and appeals) Full Case Name: Court Action Number: Where was the case filed? Please provide the full names of all parties, lawyers and law firms involved in this matter. Please be sure to include email addresses for all lawyers. Information on parties: Is this case complex (see Rule of Court 3.400)? YesNoUncertain Time estimate for hearing: Full DayHalf DayOther (Please Explain) If other time estimate, please explain: Hearing Location: Neutral site needed (to be arranged by Justice Kane at no cost to the parties)Undecided Proposed hearing date(s): Please state how Justice Kane’s fees will be split among the parties.