Appellate Screening Form PDF Details

This screening questionnaire is a key procedural document in California's appellate system. The Fifth Appellate District uses it to evaluate whether a civil appeal is a good fit for its mediation program. Below is a breakdown of what the form covers and what you need to know before completing it.

Who Must File This Form

Every party involved in a civil appeal before the Fifth Appellate District must complete this questionnaire. That includes both appellants and respondents. If you are represented by an attorney, your lawyer submits the form on your behalf. Unrepresented parties file it directly with the clerk.

The court typically sends a notice after the appeal is docketed. You must respond within the deadline stated in the notice. Failing to file on time may affect your case's eligibility for the mediation program.

What the Form Asks For

The questionnaire gathers factual details about your case so a justice can assess its suitability for mediation. You will be asked to provide:

Answer each question completely. A sitting justice reviews your responses alongside those of the opposing party to decide whether to recommend the case for mediation.

When Mediation May Be Ordered

If the court selects your case, a trained mediator works with both sides before significant resources are spent on appeal records and briefs. Mediation under this program is conducted by a sitting justice or a qualified neutral. Settlements reached at this stage are binding.

Not every case qualifies. Factors that typically weigh against selection include cases with no realistic settlement value, highly adversarial relationships, or legal questions that require a court ruling to resolve. The form's detailed questions help the court sort cases quickly.

For related legal documents, you may also need an appeal form to initiate the appellate process, or a mediation statement form if your case proceeds to a structured mediation session. Parties in California civil actions may also need to file a California civil form for related case management purposes.

QuestionAnswer
Form NameAppellate Screening Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesappellate district determine make, ca court of appeal 5th district, fifth appellate district california court of appeal, fifth appellate district

How to Edit Appellate Screening Form Online for Free

You can complete this document online without downloading any software. Our PDF editor lets you fill in text fields, add signatures, and save your work at any stage. Follow the steps below to finish the form quickly and accurately.

Step 1: Open the form in the editor

Click the "Get Form" button at the top of this page. The editor loads the document in your browser. No installation is needed.

Step 2: Complete the party information

Enter the case number, court name, and the names of all parties exactly as they appear in the trial court records. Errors here can cause the clerk to reject your submission. Double-check spelling against your original court paperwork.

Filling in party names and case number on the appellate screening form

Step 3: Describe the judgment and trial proceedings

Indicate how the trial court judgment was reached. Options include jury trial, court trial, summary judgment, arbitration, demurrer, or administrative mandamus. Also record the approximate length of the original trial or hearing. These details help the court assess the scope of the dispute.

Completing the trial court judgment section of the appellate screening form

Step 4: Disclose prior appeals and ADR history

State whether any prior appeals have been filed in this case. Describe any alternative dispute resolution processes that have already taken place, including private mediation or arbitration. If settlement talks occurred, note their outcome without disclosing privileged communications.

Prior appeals and ADR history section of the appellate screening form

Step 5: Address insurance and lien issues

Identify any insurance carriers that have a coverage interest in the case. List any liens, including attorney liens, that could affect how settlement proceeds would be distributed. Incomplete disclosure here can delay or derail a mediation agreement.

Insurance and lien disclosure fields in the appellate screening form

Step 6: State your mediation suitability assessment

Indicate whether you believe the case is suitable for mediation. If you answer No, provide a brief explanation. Be candid. A sitting justice weighs both parties' assessments when deciding whether to refer the case.

Step 7: Sign and submit

Enter the date, your signature, and your printed name in the fields at the bottom of the form. Each party or their counsel must sign separately. After all fields are complete, click "Done" to save a copy to your FormsPal account. You can then download, print, or share the finished document.

Signature, date, and printed name fields at the bottom of the appellate screening form

For other court-related documents, explore our collection of judicial branch forms and appeal request forms available on FormsPal.

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