# Suicide Watch Chronological Log

## Inmate Companions Log

Name of inmate on watch:

Epstein

Register #:

7431E.054

Institution:

Date Watch Began / Ended

7 | 23 | 19

ONLY ITEMS ALLOWED:

Sack Meal

To be completed by Chief Psychologist at conclusion of watch:

Booklet ___ of ___

Suicide Smock/Slippers

Suicide Sleeping Bag

Suicide Mattress

Paper Cup



Soap



Tampons or

Exam Canitant Ralt/Nankin



SWCL - INMATE


EFTA00110502

# 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: ___

$$\Box $$ This is a continuation log book for this watch.

Enter date and time this watch book was initiated: ___

Instructions to Observer:

Document your observations every ___ minutes.

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

EFTA00110503

<table border="1"><tr><td>Time</td><td>Observations: Briefly note your observations: initial all entries.</td></tr><tr><td>1:40am</td><td>I m Brought down to Surprise cell #4</td></tr><tr><td>1:45am</td><td>I m lying on Bed</td></tr><tr><td>2:00am</td><td>I m Sitting on Bed talking</td></tr><tr><td>2:15am</td><td>I m States his cellmate tried to kill him</td></tr><tr><td>2:30am</td><td>I m Sitting on Bed trying to remember what Happen</td></tr><tr><td>2:45am</td><td>I m Sitting on Bed</td></tr><tr><td>3:00am</td><td>I m Sitting on Bed</td></tr><tr><td>3:15am</td><td>It takes pictures of me</td></tr><tr><td>3:30am</td><td>I m Sitting on Bed</td></tr><tr><td>3:45am</td><td>I m Sitting on Bed</td></tr><tr><td>4:00am</td><td>I m Sitting on Bed</td></tr><tr><td>4:15am</td><td>I m Sitting on Bed</td></tr><tr><td>4:30am</td><td>I m Standing at Door talking</td></tr><tr><td>4:45am</td><td>I m Standing at Door talking</td></tr><tr><td>5:00am</td><td>I m Sitting on Bed</td></tr><tr><td>5:15am</td><td>I m Standing at Door</td></tr><tr><td>5:20am</td><td>I m Standing at Door</td></tr><tr><td>5:35am</td><td>I m Standing at Door</td></tr><tr><td>6:00am</td><td>I m Standing at Door</td></tr></table>

Note to all observers: Legibly print and sign your name at the beginning of your shift.

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