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Page 2547 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/28/2019 20:25 Provider; [PG (me) Unit: HO1 Follow-up in 12-24 Hours Patient Education Topics: Date Initiated Format Han i Provider Outcome 07/28/2019 Counseling Plan of Care sina Verbalizes Understanding Copay Required: No Cosign Required: Yes Telephone/Verbal Order: No Completed by?°"(°""" Requested to be cosigned by RN on 07/28/2019 20:30 Fo MG); (DMPC) Cosign documentation will be displayed on the following page. Generated 07/28/2019 20:30 by’ Bureau of Prisons - NYM Page 2 of 2 DOJ-OGR-00026207