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sessment for every one month interval thereafter? O Yes: O No if no. why not? Acts) taken on the above date by the Segregation Review Official or the Reviewing Authority: O Released from Special Housing: O Continue in Speaal Housing Did inmate in Adminisuative Detention receive a written copy of staffs decision and
a Special Housing Review: REMARKS Review By (SRO): SIGNATURE Reviewing Authority: Or Dale inmate waived right to appear. Has been seen daily by Medical Stall. O Yes: O No Has been seen daily by responsible officer designated by Warden: O yes: O No Has received prescribed weekly exorcise: K Yot O No
sessment for every one month interval thereafter? K Yes: K No if no. why not? Acton taken on the above date by the Segregation Review Official or the Reviewing Authority: K Released from Special Housing: K Conbnue vi Special Housing Did inmate In Administrative Detention recent a written copy of staffs decision and
Special Housing Review: REMARKS Review fly (SRO): SIGNATURE Reviewing Authority: Or Dale inmate warted right to appear': Has been seen daily by Medical Stall. K Yes; K No Has been seen daily by timpani/le officer designated by Warden: K Yes: K NO Has receMid prescribed weekly exercise: K Yes: K No
essment for every one month interval thereafter? K Yes: LI NO if no. why not? Action taken on the above date by the Segregation Review Official or the Reviewing Authority: K Released from Special Housing. K Continue m Special Housing Did inmate in Administrative Detention receive a written copy or staffs decision an
w By (SRO): Reviewing Authority: Date inmate appeared for a Special Housing Review; Or Date inmate waived right to appear: Has been seen daily by Medical Stall. K Yes: K No Has teen seen daily W response. officer designated by Warden: K Y0E K No Has received presented weekly exercise: K Yea: K No Pro
Entities connected to both the Reviewing Authority and Medical Stall
Next Review
ORGANIZATIONSpecial Housing Unit
ORGANIZATIONSpecial Housing Review Form
ORGANIZATIONLeon Black
PERSONFederal Bureau of Prisons
ORGANIZATION
Julie K. Brown
PERSONMedical Staff
ORGANIZATIONOHO Report
ORGANIZATIONCOMPLETED - CONTINUE PROCESSING
ORGANIZATIONUNT MGR
ORGANIZATIONCopy - Operation Supervisor
ORGANIZATIONR. PROTO
ORGANIZATIONActon Taken
LOCATIONEl Continue
ORGANIZATIONNYM-NEW YORK MCC
ORGANIZATIONPGM REVIEW
ORGANIZATIONSHU Review
ORGANIZATIONNYM CALLOUTS
PERSONCARE1-MENTAL
ORGANIZATIONNYM MED DY ST
ORGANIZATION