Alaska > Statewide > Mental Commitment

Notice To Outpatient To Return To Treatment Facility Where Committed MC-425 - Alaska

Notice To Outpatient To Return To Treatment Facility Where Committed Form. This is a Alaska form and can be used in Mental Commitment Statewide .
 Fillable pdf Last Modified 10/13/2006
Get this form for FREE as a print-only pdf

IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT In the Matter of the Necessity for the Hospitalization of: , Respondent. ) ) ) ) ) ) Case No. NOTICE TO OUTPATIENT TO RETURN TO TREATMENT FACILITY WHERE COMMITTED To: It has been determined that you can no longer be treated at as an outpatient because you are likely to cause harm to yourself or others or are gravely disabled. You must return to the treatment facility to which you were committed, , at Alaska, within 24 hours after you receive this notice. Date Signature of Provider of Outpatient Care Printed Name Title I certify that on _________________ a copy of this notice was mailed or delivered to: court respondent respondent's attorney attorney general respondent's guardian (if any) inpatient treatment facility: By: Outpatient Care Provider MC-425 (12/87)(cs) NOTICE TO OUTPATIENT TO RETURN TO TREATMENT FACILITY WHERE COMMITTED AS 47.30.795(c) American LegalNet, Inc. www.USCourtForms.com
Link/Embed this Document
URL
Embed


Popular Searches

  1. writ
  2. petition
  3. affidavit
  4. order to show cause
  5. probate
  6. Notice of Appearance
  7. motion to dismiss
  8. motion
  9. subpoena duces tecum
  10. termination of parental rights

Bookmark and Share