U.S. Equal Employment Opportunity Commission

Sample Alternative Dispute Resolution Forms

The EEOC is compiling sample Mediation Agreements, Intake Sheets, Settlement Agreements, Evaluations, and other forms in order to assist agencies in developing, or improving upon, their ADR forms. Several such forms are listed below. The Commission would welcome the submissions of any additional forms. Please email the forms to

Samples Forms:

  1. Agreements to Mediate
  2. Intake Sheets
  3. Settlement Agreements
  4. Evaluation Forms