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tions, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental con Dion, and release the Buroau of Prisons and Its employees from any and all liability for respecting and following my . . .t::.:.o .•: , • II gilt • I NYM-NEW YORK MCC EFTA00050840 BP.A061
Middle Shooting 5 MEDROL DOSE PACK 5+ Years 5+ Years NO EXERCISE MEDROL DOSE PACK Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory. Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General Appearance Yes: Appears Well, Aler
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
Middle Shooting 5 MEDROL DOSE PACK 5+ Years 5+ Years NO EXERCISE MEDROL DOSE PACK Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General Appearance Yes: Appears Well, Aler
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
Middle Shooting 5 MEDROL DOSE PACK 5+ Years 5+ Years NO EXERCISE MEDROL DOSE PACK Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General Appearance Yes: Appears Well, Aler
Entities connected to both the Buroau of Prisons and Its and Orthopedic/Rheumatology

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