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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/24/2019 13:08 Provider: [exe OME]|MLP Unit: HO1 Follow-up at Sick Call as Needed Patient Education Topics: Date Initiated Format Han i Provider Outcome 07/24/2019 Counseling Access to Care Verbalizes Understanding 07/24/2019 Counseling Preventive Health Verbalizes Understanding Copay Required: No Cosign Required: Yes Telephone/Verbal Order: No Completed by S@RSGMMLP on 07/24/2019 13:24 Requested to be cosigned by QCM p. Cosign documentation will be displayed on the following page. Generated 07/24/2019 13:24 yO ee Bureau of Prisons - NYM Page 2 of 2 DOJ-OGR-00024112