Free IN THE SUPERIOR COURT FOR THE STATE OF ALASKA - Alaska

IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT __________________ In the Matter of the Necessity for the Hospitalization of: , Respondent. ) ) ) ) ) )

Case No. NOTICE OF RESPONDENT'S ARRIVAL AT EVALUATION FACILITY

To: CLERK OF COURT , ALASKA Please take notice that respondent arrived at

on __________________________, 20_____, at _________ ___.m.

Date

Signature Printed Name Title

The Superior Court at _____________________ was notified by telephone on __________________________, 20_____ at _____________ ____.m. This notice was mailed to the court on ______________________, 20____.

Name and Title Distribution: Original to court Copy to evaluation facility

MC-400 (3/01)(st.2) NOTICE OF RESPONDENT'S ARRIVAL AT EVALUATION FACILITY

AS 47.30.715