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Page 2547 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/28/2019 20:25 Sex: M Race: WHITE Reg #: 76318-054 Provider: [b(6); (b)(7)(C)] RN Facility: NYM Unit: H01 Follow-up in 12-24 Hours Patient Education Topics: Date Initiated Format Handout/Topic Provider Outcome 07/28/2019 Counseling Plan of Care [b(6); (b)(7)(C)] Verbalizes Understanding Copay Required: No Cosign Required: Yes Telephone/Verbal Order: No Completed by [b(6); (b)(7)(C)] RN on 07/28/2019 20:30 Requested to be cosigned by [b(6); (b)(7)(C)] MD. Cosign documentation will be displayed on the following page. Generated 07/28/2019 20:30 by [b(6); (b)(7)(C)] RN Bureau of Prisons - NYM Page 2 of 2 DOJ-OGR-00026207