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Dale Pal nt's Sign YM-NEW YORK MCC EFTA00050868 @ Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 'a- Sensitive But Unclassified —I Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York O
ility for respecting and following my expressed wishes and directions. 7-10-2019 Date Patie grtature Date NYM-NEW YORK MCC EFTA00050864 NYM--NEW YORK MCC 6P-5358.C60 MEDICAL TREATMENT REFUSAL C0E RM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF FRISONS 7-24.2019 Date I, JEFFREY EPSTEIN
al Nadu of Prisons • NYM Rego 1 o! 1 EFTA00049314 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 ••• Sensitive But nclasslfleds** Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 0112W1953 Sex M Facility MCC New York Orde
-Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Phone Number: 6468366300 Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Name/Tale of Person Completing Form: Col
Bureau of Prisons - NYM Page 2 of 2 EFTA00045617 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order
y Dispensings: 21 tab in 1 day Generated 07/30/2019 15:33 by Aassiddaa, Joy FOIA Bureau of Prisons - NYM Page 1 of 2 EFTA00045568 Complex: NYM--NEW YORK MCC Begin Date: 07/02/2019 Inmate: EPSTEIN, JEFFREY Reg #: 76318-054 End Date: 07/30/2019 Quarter: Z04-206LAD Active Prescriptions Omega 3 (Vas
Bureau of Prisons - NYM Page 2 of 2 EFTA00048517 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Colle
g my expressed wishes and directions. MD 7-24-2019 Counseled by Date Patient's Sign Date ElMille! t 4 Si nature of VVitne j fe ," r NYM--NEW YORK MCC f/re-cie- EFTA00048526 BP-5353.0€0 Sit, C5 MEDICAL TREATMENT REFUSAL CDFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-10-2019 D
hD Bureau of Prisons NYM Page 2 of 2 EFTA00073969 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 ••• Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Coll
of Prisons and Its employees from any and all liability for respecting and following my expressed wishes and directions. ID 7-24-2019 Date NYM--NEW YORK MCC 7re-cie- EFTA00073976 BP-A0618 JUN 16 U.S. DEPARTMENT OF JUSTICE A&O DENTAL EXAMINATION (Initial Clinical Dental Findings) FEDERAL. BUREAU OF
Bureau of Prisons • NYM Page 1 of 1 EFTA00059492 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified "' Name EPSTEIN, JEFFREY Reg U 76318-054 DOB 01/20/1953 Sex M Facility MCC New Ycrk Ord
Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Phone Number. 6468366300 Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Namerfltle of Person Completing Form:
0 W. Sunshine Street Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IOMS) Springfield, MO 65807 417-874-1621 Facility MCC New York Order Unit E06-547U Provider t b)(6i; (bK?:(C) IMO CHEMISTRY 137 4.7 99 27 17 1.05 >60 GF
lowing my expressed wishes and directions. ,b){6); (b)(7}(C) 7-24-2019 Counseled by Date t'sSig~ Date (b)(6); (b)(7)(C) 1 nature of Wi NYM--NEW YORK MCC (b){6); (b)(7)(C) Page 2501 I BP•A0618 JUN 16 A&O DENTAL EXAMINATION (Initial Clinical Dental Findings) U.S. DEPARTMENT OF JUSTICE 5: ' 2
0 W. Sunshine Street Name EPSTEIN, JEFFREY Reg# 76318-054 DOB 01/20/1953 Sex M Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IDMS) Springfield, MO 65807 417-874-1621 Facility MCC New York Order Unit E06-547U Providerl(b)C5>; lbit7Jtc> I MD CHEMISTRY 137 4.7 99 27 17 1.05 >60 G
following my expressed wishes and directions . . b)(6); (b)(7)(C) r )(6); (b)(7)(C) 7-24-2019 Counseled by Date Date (b)(6); (b)(? )(C) NYM--NEW YORK MCC ~/r~ '----------------
0 W. Sunshine Street Name EPSTEIN, JEFFREY Reg# 76318-054 DOB 01/20/1953 Sex M Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IDMS) Springfield, MO 65807 417-874-1621 Facility MCC New York Order Unit E06-547U Provider r )(6); (b)(7)(C) f MD CHEMISTRY 137 4.7 99 27 17 1.05 >60 G
Pharmacy Dispensings: 21 tab in 286 days Generated 05/ 11/2020 09:57 bf b)(6); (b)(7)(C) IOGC Bureau of Prisons - DAN Page 1 of 2 Complex: NYM--NEW YORK MCC Begin Date: 07/06/2019 Inmate: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Active Prescriptions Omega 3 (Vascepa) 1 GM Capsule Take two capsules
e 1 of 1 S NY_00000987 EFTA_00000196 EFTA00134731 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified "' Name EPSTEIN. JEFFREY Reg U 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Ord
Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Phone Number. 6468366300 Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Namerfltle of Person Completing Form:
Entities connected to both Springfield and NEW YORK MCC

Jeffrey Epstein
PERSON
George W. Bush
PERSON
Department of Justice
ORGANIZATIONLeon Black
PERSON
Julie K. Brown
PERSON
Prince Andrew
PERSON
Ghislaine Maxwell
PERSON
Michael Jackson
PERSON
Scarlett Johansson
PERSON
United States
LOCATIONFBI
ORGANIZATION
Eric Trump
PERSONFederal Bureau of Prisons
ORGANIZATION
Metropolitan Correctional Center
ORGANIZATION
Alfredo Rodriguez
PERSON
Condoleezza Rice
PERSON
Harry Reid
PERSONSpecial Housing Unit
ORGANIZATION
Bill Richardson
PERSON
Columbia University
LOCATION