Virginia's Judicial System


Orders of Referral/Instructions

Form DC-604, “Order of Referral and Mediator Appointment Form – Custody, Visitation and Support,” is used in appropriate child custody, visitation and support cases when the court refers the case to a dispute resolution orientation session pursuant to Section 20-124.4 of the Code of Virginia.  The orientation session is conducted by a certified mediator at no expense to the parties.  If the parties choose to mediate, and continue with the court-referred mediator, the mediator is paid $100 by the Commonwealth from the funds appropriated for payment of appointments made pursuant to subsection B of Section 16.1-267 (the “criminal fund”).  Procedures for the referral are printed on the reverse side of the form.

Form DC-400, “Order of Referral,” is used in any contested civil matter or for selected issues in a civil matter, when the court on its own motion or the motion of the parties refers the matter to an orientation session pursuant to Section 8.01-576.5 of the Code of Virginia.  The orientation session is conducted by a neutral or intake specialist at no expense to the parties to assist them in determining whether their case is suitable for a dispute resolution process such as mediation.  The cost of any subsequent dispute resolution proceeding is as agreed between the neutral and the parties. Procedures for the referral are printed on the reverse side of the form.