Conditions Of Early Release To Outpatient Treatment
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Conditions Of Early Release To Outpatient Treatment Form. This is a Alaska form and can be use in Mental Commitment Statewide.
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Tags: Conditions Of Early Release To Outpatient Treatment, MC-420, Alaska Statewide, Mental Commitment
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
AT
In the Matter of the Necessity
for the Hospitalization of:
,
Respondent.
)
)
)
)
)
)
Case No.
CONDITIONS OF EARLY RELEASE
TO OUTPATIENT TREATMENT
1.
It has been determined that it is not necessary for the respondent to be treated
as an inpatient to prevent him/her from harming himself/herself or others. In
addition, there is reason to believe that the respondent's mental condition would
improve as a result of outpatient treatment.
2.
, a provider of outpatient care
located at
Alaska, has agreed to accept the
respondent for the duration of his/her commitment.
3.
Conditions of respondent's early release are:
Date
Signature of Professional Person In Charge
or that Person's Professional Designee
Print Name and Title
I certify that on
a copy of this document was mailed
or delivered to:
court
respondent
respondent's attorney
attorney general
respondent's guardian (if any)
the outpatient treatment center named above
By:
Treatment Facility Personnel
MC-420 (12/87)(cs)
CONDITIONS OF EARLY RELEASE TO OUTPATIENT TREATMENT
AS 47.30.795
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