EFTA00139075¶
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: | DDS |
| 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 HYPERTRIGLYCERIDEMIA | Current |
| Sleep apnea | Current |
| Constipation, unspecified | Current |
| Low back pain | Current |
| Neuralgia and neuritis, unspecified | Current |
| No Diagnosis | Current |
| Injury, unspecified R/O self inflicted injuries. | Current |
Medical History as of Dental Health History Encounter date: 07/26/2019 07:54¶
Allergies: Denied¶
Seizures: Denied¶
Diabetes: Denied¶
| Cardiovascular: | Denied |
CVA:¶
Denied¶
Hypertension: Denied¶
Respiratory: Denied¶
| Sickle Cell Anemia: | Denied |¶
| :--- | :--- |¶
| Carcinoma/Lymphoma: | Denied |¶
| :--- | :--- |¶
When Tested: 2019¶
| Test Result: | Negative |
|---|
When Diagnosed AIDS:¶
Hepatitis: Denied¶
Generated 07/26/2019 07:59 by¶
DDS¶
SDNY 00017439¶
- Page 1 of 3
Bureau of Prisons - NYM¶
EFTA00139076¶
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¶
| 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¶
Burning tongue: No¶
| Swelling or lumps in mouth/throat: | No |¶
| :--- | :--- |¶
Bad breath: No¶
| Decayed teeth: | No |¶
| :--- | :--- |¶
| Loose teeth: | No |¶
| :--- | :--- |¶
Wear dentures: No¶
| None: | No |¶
| :--- | :--- |¶
Comments:¶
Generated 07/26/2019 07:59 by¶
SDNY 00017440¶
- Page 2 of 3
EFTA00139077¶
| Inmate Name: EPSTEIN, JEFFREY EDWARD | Sex: M | Race: WHITE | Reg #: 76318-054 |
|---|---|---|---|
| Date of Birth: 01/20/1953 | Provider: | DDS | Facility: NYM |
| Encounter Date: 07/26/2019 07:54 | 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¶
Telephone/Verbal Order: No¶
Cosign Required: No¶
Completed by¶
DDS on 07/26/2019 07:59¶
Generated 07/26/2019 07:59 by¶
DDS¶
Bureau of Prisons - NYM¶
SDNY 00017441¶
- Page 3 of 3