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any and all liability for respecting and following my expressed wishes and directions. MD 7-24-2019 Counseled by Dale Pa nes Sign r Date NYM--NEW YORK MCC EFTA00110339 BF-A0618 JUN 16 U.S. DEPARTMENT OF JUSTICE A&O DENTAL EXAMINATION (Initial Clinical Dental Findings) FEDERAL BUREAU OF PRISONS
Nerbal Order: No Completed by Cosign Required: No MD on 07/30/2019 16:12 Prescriber Order SLIDING SCALE Subcutaneously each morning x 7 day(s) Pill Line Only Prescriber Order Inject regular insulin subcutaneously per sliding scale: twice daily "pill line"' for 7 days Generated 07/30/2019 16:12 b
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
8-NYM Insulin Reg (10 ML) 100 UNITS/ML /nj Only. Data 07/30/2019 15:58 Prescriber ()liter SLIDING SCALE Subcutaneously each morning x 7 day(s) Pill Line Only Order Date Prescriber Order 07/30/2019 15:58 Inject regular insulin subcutaneous!), per sliding scale: twice daily "'pill line"' for 7 da
-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
148-NYM Insulin Reg (10 Mt) 100 UNITS/ML lnj Order Data 07/30/2019 15:58 Prescriber Order SLIDING SCALE Subcutaneously each morning x 7 day(s) Pill Line Only Order Date Proscriber Artier 07/30/2019 15:58 Inject regular insulin subcutaneously per sliding scale: twice daily '"pill linen* for 7 da
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:
Nerbal Order: No Completed by Cosign Required: No MD on 07/30/2019 16:12 Prescriber Order SLIDING SCALE Subcutaneously each morning x 7 day(s) Pill Line Only Prescriber Order Inject regular insulin subcuteneousisi per sliding scale: twice daily "VT line*" for 7 days Generated 07/30/2019 16:12 by
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
Laboratory Requests: Prescriber Order 10 CC Orally - Two Times a Day PRN x 90 day(s) SLIDING SCALE Subcutaneously - Two Times a Day x 7 day(s) Pill Line Only Prescriber Order Take the tablet by mouth as directed x 6 day(s) Details Lab Tests - Short List-General-CBC w/diff Lab Tests-P-PSA, Total
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 Namerfitle of Person Completing Form:
oneNerbal Order: No Completed by Cosign Required: No on 07/30/2019 18:12 Prescriber Order SLIDING SCALE Subcutaneously each morning x 7 day(s) Pill Line Only Prescriber Order Inject regular insulin subcuteneouslyi per sliding scale: twice daily "'airline"' for 7 days Generated 07/30/2019 16:12 b
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:
oneNerbal Order: No Completed by Cosign Required: No on 07/30/2019 18:12 Prescriber Order SLIDING SCALE Subcutaneously each morning x 7 day(s) Pill Line Only Prescriber Order Inject regular insulin subcuteneouslyi per sliding scale: twice daily "'airline"' for 7 days Generated 07/30/2019 16:12 b
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