EFTA00140227¶
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¶
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¶
Page 1 of 3¶
DDS¶
Bureau of Prisons - NYM¶
EFTA00140228¶
| Inmate Name: | EPSTEIN, JEFFREY EDWARD | Reg #: | 76318-054 | |||||
|---|---|---|---|---|---|---|---|---|
| Date of Birth: | 01/20/1953 | Sex: M | Race: WHITE | Facility: | NYM | |||
| Encounter Date: | 07/26/2019 07:54 | Provider: | Unit: | H01 | ||||
| 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¶
Burning tongue: No¶
| Clenching or grinding: | Yes |
| Swelling or lumps in mouth/throat: | No |¶
| :--- | :--- |¶
| Decayed teeth: | No |¶
| :--- | :--- |¶
| Loose teeth: | No |¶
| :--- | :--- |¶
Wear dentures: No¶
Bad breath: No¶
| None: | No |¶
| :--- | :--- |¶
Page 2 of 3¶
Bureau of Prisons - NYM¶
EFTA00140229¶
| 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¶
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 DDS on 07/26/2019 07:59¶
Generated 07/26/2019 07:59 by¶
DDS¶
Page 3 of 3¶
Bureau of Prisons - NYM¶