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BP-AQ292 APR 16 U.S. DEPARTMENT OF JUSTICE SPECIAL HOUSING UNIT RECORD FEDERAL BUREAU OF PRISONS NEWYORK MGC _ {Institution} Inmate Name: EPSTEIN, JEFFREY EDWARD Rego, (6318-054 Tearnfeaseworker, UNASSIGNED ADMISSION Rigukar Unt Ae MANAGER ai... ABO Violation KK Date ; Time or Reason: Rec'd: oe _ Rec'd: ia Admittance Date Time Authorized: Rel. eh Rel.: sa Fertineni Information: Separation Information: #05- LA Special Housing Unit Cell Number: Jase [Inmate Is In. iil BS: ie AD Status Is Inmate on Medication: sab Medical Department Notified: wie 5 _ a errs aa Out of celi time : ~ Medical A ale Mx) tc eee xercise Staff Sign ole Signature | 5 D i 5 it (Total minfhrs) | Comments See : ; Morn Day , | ; = Eve ‘ i ‘ “o7-06-2018 ov-11-2019 | Morn ¥ o7-112019 | Day ¥ Ni Ref Sse 2nd page orit2ma] Eve ¥ af-12-2049| Morn ¥ OF-F2-2019 “Day 4 i Sae 2nd page arazzaia| Eve , vy ov-19-209) Mom ¥ “ornare | Day | y¥ o7-43-2019| Eve ¥ EXPLANATORYNOTES:Pertinent Info: i.e., Epileptic, Diabetic; Suicidal; Assaultive: etc, Meals/SH: Shower - Yes (Y); No (N); Refused {RyOutof-Cell Time: (LL) Law Library,(LV) Legal Visit, (U) Unit Team, (P} Psychology, (E} Education, (H) Halrcut, (G) Chapel, {R} Recreation, (x) Property tssue, (¥) Visit, (M} Medical, (C) Court, (0) Other — Yes (Y) #f applicable / Enter Actual Time-Period Start and End {1e., 0930 — 1030 hrs) in Out of Cell Time Bleck. Medical: Medical providers will sign the segregation tog each shift and the record sheet each time the inmate is seen by a medical provider. At a minimum, the record sheet must be signed at least once each day by the medical provider, Comments: i.¢., Conduct, Attitude, etc. Additlanal comments on reverse side must include date, signature, and title. O1C Signature: OIC must sign all record sheets each shift. (OL - Unit Officer) POF Prescribed by P4270 This form replaces BP-292(52) dated AUG 2011, DOJ-OGR-00024606