Epstein Secrets

In the reason for placement Is to be noted m this section. If the reason for placement changes, the inmate must receive a copy of Cis form): Date of Next Review 0740-2019 Rented Name and Senature of aegis° Official or the Reviewing Authoaty and Date Signed. Record Copy • Central Ftie This form replaces B

s received prescribed weekly exorcise: K Yot O No Proper documentation and justification in the Central File (Incident Report. OHO Radon, copies of Special Housing Review Form): O Yes: O No if no, why not? Is there a written psychiatric or psychological assessment on ale inmate who has spent 30 days in a special housing

ange in the reason for placement is to be noted in this What If Me reason for placement changes, the inmate must receive a copy &this form): Date of Next Review. 07.23.2019 Printed Name and Signe Segregation Review Official ea the Reviewing Authority and Date Signed. M. I Record Copy - Central File TN'

s received presented weekly exercise El Yes, K No Proper documentation and justification In the Central Fee (Incident Report. OHO Report copies of Special Housing Review Form) Yes; no, why not? Is there a written psythiatC or psychobgical assessment on the inmate who lea spent 30 days in e special hewing Status? 0 Yes

the reason for placement is to be noted in this section. If the reason for placement changes, the inmate must receive a copy of this form): Date of Next Review. 07.23.2019 lion Review Official Or the Reviewing Authority and Date Signed. This form replaces BP-295(52) dated January 1988 Page I of 1 7/19/20

s received presented weekly exercise: K Yea: K No Proper documentation and Justification in the Centel File (Incident Report. OW Report, copies of Special Housing Review Form): Yes: K No if no. why not? Is there a written psychiatric or psychological assessment on the inmate who has spent 30 days in a special housmg st

n the reason tor placement is to be noted in this section. t the reason for placement changes. the inmate must receive a copy of this form) Date of Next Review 07-25-2019 Pnnted Name and Signature of Segregation Review Official or the Reviewing Authority and Date Signed RICE, MARQUEA S Record Copy - Cent

recanted prescribed weeldy exercise: IZ Yea; El NO Proper documentation and justification in the Central Fie (Incident Report. DHO Report copes or Special Housing Review Form): Yea El No If no. why not? Is there a wntten psychiatric or psychological assessment on the inmate who has Vent 30 dale n a Waal housing status?

n the reason for placement Is to be noted in this section. If the reason for placement changes. the inmate must receive a copy of this form) Date 01 Next Review 01.23-2019 Printed Name and Sign Segregation Renew Official or the Renewing Authority and Date Signed Record Copy - Central File This form repla

as received prescnbed weekly exercise: O Yes: O No Proper doCuMentation and iuStification in the Central Fie (InteleM Report. OHO Reprt. copies 01 Special Housing Review Form): K Yes; O No d no. why not? Is Mere a written psychiatric or psychological assessment on the inmate who has spent 33 days in a special housing s

n the reason for placement is to be noted in this section. If the reason for placement changes, the inmate must receive a copy of this form) Date of Next Review: 07.23.2019 Printed Name and Signal Segregation Review Official or the Reviewing Authority and Date Signed RICE, MARQUEA S Record Copy - Central

received prescribed weekly exercise: D Yes: K No Proper documentation and justification in the Central File (Incident Report, DHO Report, copes of Special Housing Review Form): O Yes; O No if no. why not? Is there a written psychiatric or psychological assessment on the inmate who has spent 30 days in a special housing

the reason for placement is to be noted in this section. If the reason for placement changes, the inmate must receive a copy of this form): Date of Next Review: 07-26-2019 Printed Name and Signature of Segregatlon Review Official or the Reviewing Authority and Date Signed: (b)(6); (b)(7)(C) Record Copy -

received prescribed weekly exercise: ~ Yes; D No Proper documentation and justification in the Central F~e (Incident Report, DHO Report, copies of Special Housing Review Form): if no, why not? Is there a written psychiatric or psychological assessment on the inmate who has spent 30 days in a special housing status? Is t

the reason for placement is to be noted in this section. If the reason for placement changes, the inmate must receive a copy of this form): Date of Next Review: 07-26-2019 Printed Name and Signature of Segregatlon Review Official or the Reviewing Authority and Date Signed: r )(6); (b)(7)(C) 1 RecOrd C0p

received prescribed weekly exercise: ~ Yes; D No Proper documentation and justification in the Central F~e (Incident Report, DHO Report, copies of Special Housing Review Form): if no, why not? Is there a written psychiatric or psychological assessment on the inmate who has spent 30 days in a special housing status? Is t