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 ABSENCE FROM TREATMENT FACILITY TO: 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 AS 47.30.790 & .805(b) American LegalNet, Inc. www.FormsWorkFlow.com MC-430 (3/01)(cs) NOTICE OF ABSENCE FROM TREATMENT FACILITY