EFTA00134726

# Bureau of Prisons
## Health Services
## Dental Health History Screen

**Inmate Name:** EPSTEIN, JEFFREY EDWARD
**Date of Birth:** 01/20/1953
**Encounter Date:** 07/26/2019 07:54
**Sex:** M
**Race:** WHITE
**Provider:**

**Reg #:** 76318-054
**Facility:** NYM
**Unit:** H01

### ASSESSMENTS:
Health Problems as of Dental Health History Encounter date: 07/26/2019 07:54

**Health Problems**

| Health Problem | Status |
| :--- | :--- |
| Hyperlipidemia, unspecified | Current |
| HYPERTRIGLYCERIDEMIA | |
| Sleep apnea | Current |
| Constipation, unspecified | Current |
| Low back pain | Current |
| Neuralgia and neuritis, unspecified | Current |
| No Diagnosis | Current |
| Injury, unspecified | Current |
| R/O self Inflicted Injuries. | |

Medical History as of Dental Health History Encounter date: 07/26/2019 07:54

**Medical History:**

| Medical History: |
| :--- |
| Allergies: | Denied |
| Seizures: | Denied |
| Diabetes: | Denied |
| Cardiovascular: | Denied |
| CVA: | Denied |
| Hypertension: | Denied |
| Respiratory: | Denied |
| Sickle Cell Anemia: | Denied |
| Carcinoma/Lymphoma: | Denied |

HIV History:

| When Tested: | 2019 |
| Test Result: | Negative |
| When Diagnosed AIDS: | |
| Last CD4: | |
| Comments: | |

Hepatitis: | Denied |

Generated 07/26/2019 07:59 by Ancrum, Cheryl DDS

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Bureau of Prisons - NYM

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### Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953
Encounter Date: 07/26/2019 07:54

#### Other Infectious Diseases:
- Syphilis: No
- Syphilis Last Treatment: N/A
- Genital Warts: No
- Chlamydia: Yes
- Gonorrhea: No
- Herpes: No
- Chicken Pox: Yes
- Other: No

#### Comments: Chlamydia in 2015, treated
Chicken pox in childhood

#### Other Health Issues:
- Other Medical Conditions And Treatment: sleep apnea
- Current Medical Conditions:
- Other Current Treatments:

#### Pregnant: N/A

## Dental Observations as of Dental Health History Encounter date: 07/26/2019 07:54

### History:
- Alcohol: No
- Methamphetamine: No
- Tobacco products: No
- Other drugs: No
- Sensitive teeth: No
- Bleeding gums: Yes
- Food impaction: Yes
- Pain around ear: No
- Toothache: No
- Wear partial dentures: No
- Unusual sounds while eating: No
- Snoring: Yes
- Blisters on lips or mouth: No
- Clenching or grinding: Yes
- Swelling or lumps in mouth/throat: No
- Burning tongue: No
- Bad breath: No
- Decayed teeth: No
- Loose teeth: No
- Wear dentures: No
- None: No

### Comments:
Generated 07/26/2019 07:59 by Bureau of Prisons - NYM



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| Inmate Name: EPSTEIN, JEFFREY EDWARD | Sex: M | Race: WHITE | Reg #: 76318-054 |
| :--- | :--- | :--- | :--- |
| Date of Birth: 01/20/1953 | | | Facility: NYM |
| Encounter Date: 07/26/2019 07:54 | Provider: | | Unit: H01 |

**Cardiac Condition Requiring Prophylaxis:** No

**Prosthetic Joint(s):** No

**Radiation history of head or neck:** No

**Excessive bleeding:** No

**Bisphosphonates:** No

**Comments:**

**Medications as of Dental Health History Encounter date:** 07/26/2019 07:54

**Medications:**
- Docusate Sodium 100 MG Cap Exp: 08/11/2019 SIG: Take one capsule (100 MG) by mouth twice daily for 30 days
- Omega 3 (Vascepa) 1 GM Capsule Exp: 01/13/2020 SIG: Take two capsules (2 GM) twice daily by mouth with food

**OTCs: Listing of all known OTCs this inmate is currently taking.**

Instructed inmate how to obtain medical, dental, and mental health care.

**Copay Required:** No
**Cosign Required:** No

**Telephone/Verbal Order:** No

Completed by on 07/26/2019 07:59

Generated 07/26/2019 07:59 by

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Bureau of Prisons - NYM



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