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Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/24/2019 13:08 Sex: M Race: WHITE Reg #: 76318-054 Provider: [b(6), b(7)(C)] MLP Facility: NYM Unit: H01 Follow-up at Sick Call as Needed Patient Education Topics: Date Initiated Format Handout/Topic Provider Outcome 07/24/2019 Counseling Access to Care [b(6), b(7)(C)] Verbalizes Understanding 07/24/2019 Counseling Preventive Health [b(6), b(7)(C)] Verbalizes Understanding Copay Required: No Cosign Required: Yes Telephone/Verbal Order: No Completed by [b(6), b(7)(C)] MLP on 07/24/2019 13:24 Requested to be cosigned by [b(6), b(7)(C)] MD. Cosign documentation will be displayed on the following page. Generated 07/24/2019 13:24 by [b(6)] MLP Bureau of Prisons - NYM Page 2 of 2 DOJ-OGR-00024112