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Fill and Sign the Mc 430 Notice of Absence from Treatment Facility 3 01 Fill in Mental Commitment Forms

Fill and Sign the Mc 430 Notice of Absence from Treatment Facility 3 01 Fill in Mental Commitment Forms

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MC -430 (3/01)( cs) AS 47.30.790 & .805(b) NOTICE OF ABSENCE FROM TREATMENT FACILITY IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT __________________ In the Matter of the Necessity ) for the Hospitalization of: ) ) , ) Case No. Respondent. ) ) NOTICE OF ABSENCE FROM TREATMENT FACILITY T O: Superior Court at , Respondent's Attorney , Respondent's Guardian , Assistant Attorney General , Person previously threatened by the Respondent You are hereby given notice that the above-named respondent was absent without permission since , 20____. This facility shall notify you promptly of his/her return to the facility. Date Signature Print Name Title I certify that on a copy of this notice was sent to (list names): By: Treatment Facility Personnel

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