EFTA00139031

# Bureau of Prisons
Health Services
Clinical Encounter - Administrative Note

| Inmate Name: | EPSTEIN, JEFFREY EDWARD |
| :--- | :--- |
| Date of Birth: | 01/20/1953 |
| Note Date: | 07/07/2019 00:17 |

| Sex: M | Race: WHITE |
| :--- | :--- |
| Provider: MD | Unit: E06 |

Cosign Note - Intake Cosign encounter performed at Health Services.

Administrative Notes:

<table><thead><tr><th>ADMINISTRATIVE NOTE</th><th>1</th><th>Provider:</th><th>MD</th></tr></thead><tbody><tr><td colspan="4">MED CL:1<br>NO CCC APPT.</td></tr></tbody></table>

## Discontinued Laboratory Requests:

<table><thead><tr><th>Details</th></tr></thead><tbody><tr><td>Lab Tests-H-Hemoglobin A1C</td></tr><tr><td>Lab Tests-C-CBC w/diff</td></tr><tr><td>Lab Tests-L-Lipid Profile</td></tr><tr><td>Lab Tests-C-Comprehensive Metabolic Profile (CMP)</td></tr></tbody></table>

<table border="1"><tr><td>Frequency</td><td>Due Date</td><td>Priority</td></tr><tr><td>One Time</td><td>08/05/2019 00:00</td><td>Routine</td></tr></table>

<table><tr><td>Additional Information:</td></tr><tr><td>66 y/o male, elevated BP</td></tr><tr><td>Labs requested to be reviewed by:</td></tr></table>

New Laboratory Requests:



<table><thead><tr><th>Frequency</th></tr></thead><tbody><tr><td>One Time</td></tr></tbody></table>

<table><tr><td>Chronic Care Clinics-Diabetic-CBC w/diff</td></tr><tr><td>Chronic Care Clinics-Diabetic-Lipid Profile</td></tr><tr><td>Chronic Care Clinics-Diabetic-Hemoglobin A1C</td></tr><tr><td>Lab Tests-H-HIV 1/2</td></tr><tr><td>Lab Tests-R-RPR</td></tr><tr><td>Chronic Care Clinics-Diabetic-Comprehensive Metabolic Profile (CMP)</td></tr></table>

<table border="1"><tr><td>Due Date</td><td>Priority</td></tr><tr><td>07/25/2019 00:00</td><td>Routine</td></tr></table>

New Radiology Request Orders:

Specific reason(s) for request (Complaints and findings):

66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR.

Copay Required: No

Cosign Required: No

Telephone/Verbal Order: No

Completed by MD on 07/07/2019 00:30

Generated 07/07/2019 00:30 by

MD

Bureau of Prisons - NYM