Appellate Screening Form – Fill Out and Use This PDF

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:

• The nature of the trial court judgment being appealed, including whether it resulted from a jury trial, court trial, summary judgment, arbitration, demurrer, or administrative mandamus
• The length of the original trial or hearing
• Whether prior appeals have been filed in the case
• Information about existing alternative dispute resolution processes, if any
• Any relationships between the parties that could affect a negotiated resolution
• Insurance coverage details and any outstanding liens that might complicate a settlement
• Your honest assessment of whether the case is suitable for mediation and, if not, your reasons

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.