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d Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: MLP Location: Drug Mfg: Lot Number: Dosage: Routo: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: MLP Location: Drug Mfg: Lot Number: Dosage: Rou
ations, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental CO Won, and release the Buroau of Prisons and Its employees from any and all liability for respecting and f• owing my expressed wishes and directions. MD 7-24-2019 Counseled by Date Signature
d Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: MLP Location: Drug Mfg: Lot Number: Dosage: Routo: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: MLP Location: Drug Mfg: Lot Number: Dosage: Rou
ations, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental CO 'Won, and release the Buroau of Prisons and Its employees from any and all liability for respecting and f• owing my expressed wishes and directions. 7-24-2019 Counseled by Dale e a is Sign
stered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Routo: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route:
ations, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental CO Won, and release the Buroau of Prisons and Its employees from any and all liability for respecting and f• owing my expressed wishes and directions. 7-24-2019 Counseled by Date a** si .nature
stered Documented Date: 07/09/2019 12:51 EST Immunization Dato: Provider: Location: Drug Mfg: Lot Number: Dosage: Routo: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route:
ations, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental CO 'Won, and release the Buroau of Prisons and Its employees from any and all liability for respecting and f• owing my expressed wishes and directions. 7-24-2019 Counseled by Dale a is Sign NYM
Entities connected to both Smallpox Series Administration: History and the Buroau of Prisons and Its

Jeffrey Epstein
PERSONVaricella Series Administration: History Unknown
ORGANIZATION
Ghislaine Maxwell
PERSONVascepa
ORGANIZATIONNew Radiology
ORGANIZATION
Achilles
PERSON
George W. Bush
PERSONOrthopedic/Rheumatology
ORGANIZATIONVesicular Breath Sounds Bilaterally
PERSONDiscontinued Laboratory
ORGANIZATIONRDW-CV
ORGANIZATIONSpecial Housing Unit
ORGANIZATIONPHILIPS RESPIRONICS
ORGANIZATION
Mount Sinai Hospital
ORGANIZATIONROS Comments
ORGANIZATION
Springfield
LOCATIONSickle Cell Trait/Disease
ORGANIZATION
Metropolitan Correctional Center
ORGANIZATIONHYPERT
ORGANIZATIONAAOX3
ORGANIZATION