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Virtual Mediation

Strategic Conflict Resolution Session: Intake Questionnaire

Welcome to our Trauma-Informed mediation practice. Please provide your information and help us understand your needs.

First name

Last name

Email address

Phone number

Choose your service:

Marriage Mediation

Divorce Mediation

Mediation Prep

Professional Life Coaching

How aligned are both parties regarding mediation?

Not applicable

Both agree to mediate

Mostly agree

High conflict

What is the current status of asset discussions between parties?

Not applicable

Fully discussed

Partially discussed

Not started

What is your preferred timeline for beginning your session?

Just exploring

As soon as possible

Within 30 days

1-3 months

Are there any active or pending legal/court proceedings I should be aware of?

Yes

Not yet, but headed in that direction

What matters most to you in selecting a mediator or professional life coach?

Professional Boundaries & Disclaimer

By checking the box below, you acknowledge that Dr. Se'Lena is a trauma-informed, registered Civil & Domestic Relations Mediator with a Domestic Violence specialization, and a Professional Life Coach who provides strategic conflict resolution consulting and mediation frameworks.

These sessions are strictly educational and goal-oriented; they do not constitute licensed clinical therapy, mental health diagnosis, or formal legal representation.

15-Minute Laser Strategy Call for $49

$49

Schedule an appointment

June 2026

Week starting Sunday, June 21

Time zone: Coordinated Universal Time (UTC)Phone call

Wednesday, Jun 24

10:00 AM - 11:00 AM

11:00 AM - 12:00 PM

12:00 PM - 1:00 PM

1:00 PM - 2:00 PM

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Virtual Mediation

Strategic Conflict Resolution Session: Intake Questionnaire

Professional Affiliations