Authorization/Limited Power of Attorney

The undersigned [name], spouse [or other relationship such as mother, father, etc.] of [attending party] hereby designates [attending party] as my official spokesperson and attorney in fact for purposes of a mediation session now scheduled for [date] at the offices of [mediator]. The mediation relates to [incident such as auto collision, etc.] that occurred on or about [date] in the city of [location].

My representative may speak on my behalf, enter into negotiations, and sign any necessary documents including settlement agreements, releases, or other documents effectuating settlement of this claim.

This authorization form/limited...