CN-510 ANCH (6/18)(cs) CINA THERAPEUTIC COURT - FINAL ELIGIBILITY DECISION IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT ANCHORAGE In the Matter of: ) ) ) ) ) ) CASE NO(s). ) Minor(s) under 18 years of age. ) CINA THERAPEUTIC COURT - ) FINAL ELIGIBILITY DECISION ) Participant(s) Name(s): Date of Meeting: In order for the participant to be eligible, all of the following must apply: Participant has a CINA case alleging jurisdiction under AS 47.10.011(10). Participant agrees to abide by the terms and requirements of the CTC as outlined in the CTC Acknowledgement of Program Requirements document. CTC Team has determined there is no automatic legal disqualification 1 and found the participant is appropriate. The goal of the CINA case is reunification. Participant is over the age of 18. Participant has the ability to attend court in person. Participant has an assessment, treatment is available, and participant agrees with treatment recommendation. Participant has consulted with counsel regarding CTC participation and the proposed treatment recommendation. 2 CTC has the capacity to accept the participant at this time. 1 OCS will provide and distribute participant criminal history in advance of meeting. 2 Counsel must meet with client to review program obligations, and recommended treatment, in advance of meeting. American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 CN-510 ANCH (6/18)(cs) CINA THERAPEUTIC COURT - FINAL ELIGIBILITY DECISION Eligibility Decision Participant is eligible The above participant is accepted into CTC. Participant is ineligible The above participant is not admitted to CTC for the following reasons: Effective Date Superior Court Judge Type or Print Name I certify that on a copy of this document was emailed/hand-delivered to: AG PD OCS Tribe GAL OPA-AJR OPA-ASD OPA-CLS Clerk: American LegalNet, Inc. www.FormsWorkFlow.com