EFTA00073844

Inmate Name: EPSTEIN, JEFFREY EDWARD

Date of Birth: 01/20/1953

Encounter Date: 07/28/2019 20:25

Sex:

Provider:

<table border="1"><tr><td>Reg #:</td><td>76318-054</td></tr><tr><td>Facility:</td><td>NYM</td></tr><tr><td>Unit:</td><td>H01</td></tr></table>

Follow-up in 12-24 Hours

<table border="1"><tr><td colspan="2">Patient Education Topics:</td></tr><tr><td>Date Initiated</td><td>Format</td></tr><tr><td>07/28/2019</td><td>Counseling</td></tr></table>

Handout/Topic

Plan of Care

Copay Required: No

Cosign Required: Yes

Telephone/Verbal Order: No

**Outcome**

Verbalizes

Understanding

Completed by RN on 07/28/2019 20:30

Requested to be cosigned by

Cosign documentation will be displayed on the following page.

# Page 014 of 148

Withheld pursuant to exemption

(b)(6) ; (b)(7)(A) ; (b)(7)(C)

Freedom of Information and Privacy Act

Generated 07/28/2019 20:30 by

RN

Page 2 of 2

Bureau of Prisons - NYM

EFTA00073845

# Bureau of Prisons
Health Services
Cosign/Review

Inmate Name: EPSTEIN, JEFFREY EDWARD

Date of Birth: 01/20/1953



Reg #: 76318-054



Sex:

Provider:

Encounter Date: 07/28/2019 20:25

Cosigned by

Facility: NYM

Withheld pursuant to exemption

(b) (6) ; (b)(7)(A) ; (b)(7)(C)

of the Freedom of Information and Privacy Act

Bureau of Prisons - NYM