10-471

[For use in abuse, neglect and termination

of parental rights proceedings]

STATE OF NEW MEXICO

COUNTY OF _______________

___________ JUDICIAL DISTRICT

IN THE CHILDREN'S COURT

No. ___________

In the Matter of __________________,

(insert name of each child)

State of New Mexico

Children, Youth and Families

Department, petitioner

v.

__________________________, respondent

REPORT OF MEDIATION¹

We the undersigned, participated in a mediation session today, __________________ (date).

We acknowledge that the purpose of this meeting is to candidly discuss and attempt to resolve outstanding issues in this case. Pursuant to Rule 11-408 NMRA of the Rules of Evidence, any opinions, admissions and comments made during this proceeding are confidential. Except as otherwise provided by the Rules of Evidence of Children's Code, these opinions, admissions and comments are not subject to discovery, and cannot be used as an admission or for any other purpose by any party in any proceeding governing this action. New information of abuse or neglect is subject to being reported pursuant to the Children's Code.

Signatures:

_________________________                                  _________________________

Mediator                                                                     Children's Court Attorney

_________________________                                  _________________________

Respondent                                                                 Respondent's Attorney

_________________________                                  _________________________

Social Work Supervisor                                             Social Worker

_________________________                                  _________________________

Guardian ad litem                                                       CASA

_________________________                                  _________________________

Other                                                                          Other

(To be completed by mediator. Choose one.)

___      parties reached complete agreement

___      parties reached a partial agreement

___      no agreement was reached

___      continued

___      reset

___      vacated

USE NOTE

1.         Form 6559 NTC: Report of Mediation. For use in neglect and abuse proceedings. The children's court attorney shall file this report with the court and provide a copy to each party to the proceeding.

[Approved, effective September 1, 2005.]