EFTA00073871

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# Bureau of Prisons
Health Services
Clinical Encounter - Administrative Note

| Inmate Name: | EPSTEIN, JEFFREY EDWARD |
| :--- | :--- |
| Date of Birth: | 01/20/1953 |
| Note Date: | 07/12/2019 09:06 |

| | |
| :--- | :--- |
| Sex: | M Race:WHITE |
| Provider: | |
| Reg #: | 76318-054 |
| Facility: | NYM |
| Unit: | Z05 |

Admin Note - Orders encounter performed at Health Services.

Administrative Notes:

ADMINISTRATIVE NOTE 1 Provider:

PATIENT REQUESTED TO HAVE A COLACE RX , INSTEAD OF TEH BISACODYL FOR CONSTIPATION.

New Medication Orders:

<table><thead><tr><th>Rx#</th><th>Medication</th></tr></thead><tbody><tr><td></td><td>Docusate Sodium Capsule</td></tr></tbody></table>

<table><thead><tr><th>Order Date</th></tr></thead><tbody><tr><td>07/12/2019 09:06</td></tr></tbody></table>

Indication: Constipation, unspecified



Prescriber Order



Discontinued Medication Orders:

<table><thead><tr><th>Rx#</th><th>Medication</th></tr></thead><tbody><tr><td>121757-NYM</td><td>Bisacodyl E.C. 5 MG TAB</td></tr></tbody></table>



TAKE ONE 100 MG CAP Orally

- Two Times a Day x 30 day(s)



<table><thead><tr><th>Order Date</th></tr></thead><tbody><tr><td>07/12/2019 09:06</td></tr></tbody></table>

Discontinue Type: When Pharmacy Processes

Discontinue Reason: **discontinuing** withheld pursuant to exemption Indication:

Prescriber Order



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



Copay Required: No

Telephone/Verbal Order: No

Cosign Required: No of the Freedom of Information and Privacy Act

Take one tablet (5 MG) by mouth at bedtime AS NEEDED for 10 days

Completed by on 07/12/2019 09:10

Generated 07/12/2019 09:10 by

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Bureau of Prisons - NYM