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 RELEASE

To: Superior Court at ________________________, Alaska. Release After Evaluation. Respondent was admitted to ____________________________ for evaluation on ___________________, 20______ and was discharged from the facility on __________________, 20_____, at _______ ___.m. because the evaluation personnel did not find that respondent met the standards for commitment specified in AS 47.30.700. Release After Commitment Period. Respondent was committed for treatment on ___________________________, 20______, for _____ days. Respondent was released on ___________________________, 20______. Certificate of Early Discharge. Respondent was committed for treatment on _______________________________, 20_____, for ______ days. I certify that on _______________________________, 20_____, respondent was discharged early because: respondent is no longer gravely disabled or likely to cause serious harm as a result of mental illness. ___________________________________________________________________ ___________________________________________________________________ I request the court to enter an order officially terminating the involuntary commitment.

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MC-410 (3/01)(st.2) NOTICE OF RELEASE

AS 47.30.720 AS 47.30.725(b) AS 47.30.780