EFTA00056058

# Suicide Watch Chronological Log

Inmate Companions Log

Name of inmate on watch:

76318-054

To be completed by Chief Psychologist at conclusion of watch:

Booklet of

ONLY ITEMS ALLOWED:

Suicide Smock/Slippers

Suicide Blanket

Suicide Mattress

Paper Cup/Soap



SW Paper Spoon



Finger Toothbrush

Tampons or Foam Belt/Napkin



SWCL · INMATE




EFTA00056059


# STAPLE LOCAL PROCEDURES HERE

Check one of the following:



□ This is the initial log book for this suicide watch.



Enter date and time watch began:

This is a continuation log book for this watch.

Enter date and time this watch book was initiated:

7:23:09 17:00am

Instructions to Observer:

Document your observations every 15



Legibly print **and** sign your name at the beginning of your shift.