Page 2564 Inmate Name: EPSTEIN, JEFFREY EDWARD Bureau of Prisons Health Services Clinical Encounter Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/14/2019 17:36 Provider: Cb)<5) <b)l7)cc> MD Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: i<bX5>: tb)(?)(c > IMO Chief Complaint: ENDO/LIPID Subjective: 66 YR OLD WHITE MALE WITH HX OF Reg#: 76318-054 Facility: NYM Unit: Z0S HYPERTRIGLYCERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS 800 , NOW 431 . STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MEDS DUE TO THEIR GI SIDE EFFECTS. HX OF OBSTRUCTUVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. STATES HE HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES THE FBI LOKELY HAS L4 - LS SEVERE STENOSIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREMITIES. SURGICAL HX: NONE MENTAL HEALTH HX: NONE Pain: Yes Pain Assessment Date: Location: Quality of Pain: Pain Scale: Intervention: Trauma Date/Year: Injury: Mechanism: Onset: Duration: 07/12/2019 13:25 Back-Middle Shooting 5 MEDROL DOSE PACK 5+ Years 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: Seen for clinic(s): Orthopedic/Rheumatology, Pulmonary/Respiratory, Endocrine/Lipid Added to clinic(s): Orthopedic/Rheumatology, Pulmonary/Respiratory, Endocrine/lipid OBJECTIVE: Exam: General Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unkempt, Acutely Ill Nutrition No: Appears Obese Generated 07/14/2019 18:1 1 b~,,,...'.b)(,..,.,.6l,.....,; (b...,., )(7=)cc,,.,...)---.~ D Bureau of Prisons - NYM Page 1 of 3

Page 2565 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/14/2019 17:36 Provider: Cb,(5>;(b)C7)(C) MD Exam: Eyes General Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rate and Rhythm (RRR), Normal S1 and S2 No: M/R/G Abdomen Auscultation Yes: Normo-Active Bowel Sounds Palpation Yes: Within Normal Limits Musculoskeletal Tibia / Fibula No: Edema Back Yes: Tenderness Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam ASSESSMENT: Constipation, unspecified, K5900 - Current Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Rx# Medication Omega 3 ( Vascepa) 1 GM Capsule Indication: Hyperlipidemia, unspecified New Laboratory Requests: Order Date 07/14/2019 17:36 Reg#: 76318-054 Facility: NYM Unit: Z05 Prescriber Order TAKE 2 CAPS Orally - Two Times a Day x 180 day(s) -- TAKE WITH FOOD. Details Lab Tests-H-Hemoglobin A1C Lab Tests-L-Lipid Profile Frequency One Time Due Date 10/10/2019 00 :00 Priority Routine Additional Information: Generated 07/14/2019 18:1 1 byl(b)(6); (b)(?)(C) Bureau of Prisons - NYM Page 2 of 3

Page 2566 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Reg#: 76318-054 Facility: NYM Encounter Date: 07/14/2019 17:36 Provider: fb>(6); tb)(7)tc> ~ D Unit: Z05 FASTING. Lab Tests-H-Hep B surface Ab Lab Tests-H-Hep B surface Ag Lab Tests-H-Hep C Ab Lab Tests-H-Hepatic Profile Schedule: Activity Clinical Encounter One Time 08/08/2019 00:00 Date Scheduled Scheduled Provider 07/24/2019 00:00 Optometrist 66 YR OLD MALE FOR ROUTINE SCREENING. Chronic Care Visit 6 MONTH F/U. Chronic Care Visit Other: 01 /07/2020 00:00 Mid-Level Provider 07/01/2020 00:00 Physician 01 PENDING EKG AND FOBT. CXR WAS REFUSED. Patient Education Topics: Date Initiated Format 07/14/2019 Counseling Copay Required: No Telephone/Verbal Order: No Handout/Topic Diagnosis Cosign Required: No Completed by~[b_lc 5_>;(-bi(- 7)c_c> ___ ~IMD on 07/14/2019 18:1 1 Generated 07/14/2019 18:11 b f bl(5>; (b){7)(C) Bureau of Prisons - NYM Routine Outcome Verbalizes Understanding Page 3 of 3

Page 2567 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Bureau of Prisons Health Services Clinical Encounter Sex: M Race: WHITE Provider: r )(5); (b)(7)(C) ~ D Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider=~r-)[ 5 -); (_b~- 7 )(-C ) ___ __.IMD Chief Complaint: ENDO/LIPID Reg#: 76318-054 Facility: NYM Unit: Z0S HYPER G CERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS Subjective: 66 YR- HITE MALE WITH HX OF 800 , . STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MED EIR GI SIDE EFFECTS. HX OF UVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES TH Y HAS L4 - LS SEVERE SIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREM S.~ SURGICAL HX: NONE MENTAL HEALTH HX: Pain: Yes ~ Pain Assessment Date: 07/12/2019 13:25 Location: Back-Middle ~ Quality of Pain: Shooting \. ~ Pain Scale: 5 ...-~ ;:~::::~/Year: MEDROL DOSE PACK % Injury: Mechanism: Onset: 5+ Years Duration: 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: 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, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unkempt, Acutely Ill Nutrition No: Appears Obese Generated 07/12/2019 14:20 b~,.,,.. (bl=l5l'""" ; (b'°"')(7= Jcc"'">----,~ D Bureau of Prisons - NYM Page 1 of 3

Page 2568 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Exam: Eyes General Sex: M Race: WHITE Provider: 11b)16);(b)(?)(c) IMD Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular R~ t Rhythm (RRR), Normal S1 and S2 No: M/R/G Abdomen Auscultation ~ Yes: Normo-Active B s Palpation Yes: Within Normal Limits ~ Musculoskeletal ~ T~ :i:~f :~~:::mess ~ ~ Neurologic \. ~~ Cranial Nerves (CN) ~ Reg#: 76318-054 Facility: NYM Unit: Z05 Yes: Within Normal Limits v~ ASSESS::t:;,~~~:,: : ~:: :I ~ ~ Constipation, unspecified, K5900 - Current \. ~ Hyperlipidemia, unspecified, E785 - Current ~? Low back pain, M545 - Current .., ~ Neuralgia and neuritis, unspecified, M792 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Rx# Medication Magnesium Hydroxide Susp Indication: Constipation, unspecified MethylPREDNISolone Tab 4 MG ( Dose Pack 21 tab) Order Date 07/12/2019 13:10 07/12/2019 13:10 Indication: Neuralgia and neuritis, unspecified Disposition: Generated 07/12/2019 14:20 b~,b)l6); (b)(7)(C) Bureau of Prisons - NYM Prescriber Order 30 CC Orally - Two Times a Day PRN x 2 day(s) AS DIRECTED Orally - daily x 6 day(s) Page 2 of 3

Page 2569 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Follow-up at Sick Call as Needed Other: Sex: M Race: WHITE Provider: 'b)(5); (b)(7)cc> MD WILL CONTINUE NOTES TO ADDRESS THE NFDR AND FOLLOW-UP. Patient Education Topics: Date Initiated Format 07/12/2019 Counseling Copay Required: No Telephone/Verbal Order: Completed b (b)(6); <b:C?)(c J Generated 07/12/2019 14:20 byr b)(5); (b)(?)(C) Handout/Topic Diagnosis Cosign Required: No n 07/12/2019 14:20 Bureau of Prisons - NYM Reg#: 76318-054 Facility: NYM Unit: Z05 Provider l(b)(6); (b)(7)(C) Outcome Verbalizes Understanding Page 3 of 3

Page 2570 Inmate Name: EPSTEIN, JEFFREY EDWARD Bureau of Prisons Health Services Clinical Encounter Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/12/2019 13:10 Provider: 'bl(6);(bl<7:<c> MD Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider:~r )_(6)_; (b- )(?- )(C_ > ___ ~I MD Chief Complaint: ENDO/LIPID Reg#: 76318-054 Facility: NYM Unit: Z0S HYPER G CERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS Subjective: 66 YR- HITE MALE WITH HX OF 800 , . STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MED EIR GI SIDE EFFECTS. HX OF UVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES TH Y HAS L4 - LS SEVERE SIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREM S.~ SURGICAL HX: NONE MENTAL HEALTH HX: Pain: Yes ~ Pain Assessment Date: 07/12/2019 13:25 Location: Back-Middle ~ Quality of Pain: Shooting \. ~ Pain Scale: 5 ...-~ ;:~::::~/Year: MEDROL DOSE PACK % Injury: Mechanism: Onset: 5+ Years Duration: 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: 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, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unkempt, Acutely Ill Nutrition No: Appears Obese Generated 07/12/2019 14:20 b~(b)(6); (b)(7)(Cl Bureau of Prisons - NYM Page 1 of 3

Page 2571 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Exam: Eyes General Sex: M Race: WHITE Provider: t b>C6J (b)(7)(C) I MD Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular R~ t Rhythm (RRR), Normal S1 and S2 No: M/R/G Abdomen Auscultation ~ Yes: Normo-Active B s Palpation Yes: Within Normal Limits ~ Musculoskeletal ~ T~ :i:~f :~~:::mess ~ ~ Neurologic \. ~~ Cranial Nerves (CN) ~ Reg#: 76318-054 Facility: NYM Unit: Z05 Yes: Within Normal Limits v~ ASSESS::t:;,~~~:,: : ~:: :I ~ ~ Constipation, unspecified, K5900 - Current \. ~ Hyperlipidemia, unspecified, E785 - Current ~? Low back pain, M545 - Current .., ~ Neuralgia and neuritis, unspecified, M792 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Rx# Medication Magnesium Hydroxide Susp Indication: Constipation, unspecified MethylPREDNISolone Tab 4 MG ( Dose Pack 21 tab) Order Date 07/12/2019 13:10 07/12/2019 13:10 Indication: Neuralgia and neuritis, unspecified Disposition: Generated 07/12/2019 14:20 b ~ (b)(6); (b)(7)(C) jMD Bureau of Prisons - NYM Prescriber Order 30 CC Orally - Two Times a Day PRN x 2 day(s) AS DIRECTED Orally - daily x 6 day(s) Page 2 of 3

Page 2572 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Follow-up at Sick Call as Needed Other: Sex: M Race: WHITE Provider: 'b)(6); (b)(7)CC> D WILL CONTINUE NOTES TO ADDRESS THE NFDR AND FOLLOW-UP. Patient Education Topics: Date Initiated Format 07/12/2019 Counseling Copay Required: No Telephone/Verbal Order: Completed by .blC6>: (b)(7)(c ) Generated 07/12/2019 14:20 b f b>(5>; (b)(7)(C) Handout/Topic Diagnosis Cosign Required: No n 07/12/2019 14:20 Bureau of Prisons - NYM Reg#: 76318-054 Facility: NYM Unit: Z05 Provider r )(6): (b)(7)(C) Outcome Verbalizes Understanding Page 3 of 3

Page 2573 Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1 953 Sex: M Encounter Date: 07/14/201917:36 Amendment made to this note b ~~~)-( 5 >-; (b- )(7- )(c_ > ___ ~ IMD on 07/14/201918:11 . Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM

Page 2574 Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Note Date: 07/12/2019 09:06 Provider: Admin Note - Orders encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: f0l(5> <t>J[7J(c> IMD Reg#: Facility: Unit: 76318-054 NYM Z05 PATIENT REQUESTED TO HAVE A COLACE RX, INSTEAD OF TEH BISACODYL FOR CONSTIPATION. New Medication Orders: .B.xtt Medication Docusate Sodium Capsule Indication: Constipation, unspecified Discontinued Medication Orders: Rx# Medication 121757-NYM Bisacodyl E.G. 5 MG TAB Order Date 07/12/2019 09:06 Order Date 07/12/2019 09:06 Discontinue Type: When Pharmacy Processes Discontinue Reason: discontinue Indication: Copay Required: No Telephone/Verbal Order: No Cosign Required: No Completed by._ jtt>_>( 5 _);(_b1[7_l(_c> ___ _.IMD on 07/12/2019 09:10 Generated 07/12/2019 09:10 b f b)(B); (b)(7j(C) Bureau of Prisons - NYM Prescriber Order TAKE ONE 100 MG CAP Orally - Two Times a Day x 30 day(s) Prescriber Order Take one tablet (5 MG) by mouth at bedtime AS NEEDED for 10 days Page 1 of 1

Page 2575 Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: Reg#: Date of Birth: EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: M Race:WHITE Facility: Note Date: 07/07/2019 00:17 Provider: libl(6>; ib)(7)(c > ~ D Unit: Cosign Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 MED CL:1 Provider: .... f b_,(6_>; <_b;c_7)(_c > ___ _.I MD NO CCC APPT. Discontinued Laboratory Requests: Details Lab T ests-H-Hemog/obin A 1 C Lab Tests-C-CBC w/diff Lab Tests-L-Lipid Profile Lab T ests-C-Comprehensive Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Reflex to Microscopic Additional Information: 66 y/o male, elevated BP Frequency One Time Labs requested to be reviewed by: Beaudouin, Robert MD New Laboratory Requests: Details Chronic Care Clinics-Diabetic-CBC w/diff Chronic Care Clinics-Diabetic-Lipid Profile Chronic Care Clinics-Diabetic-Hemoglobin A 1 C Lab Tests-H-HIV 1/2 Lab Tests-R-RPR Chronic Care Clinics-Diabetic-Comprehensive Metabolic Profile (CMP} New Radiology Request Orders: Frequency One Time Details Frequency End Date Due Date 08/05/2019 00:00 Due Date 07/25/2019 00:00 Due Date General Radiology-Chest-2 Views One Time 07/25/2019 Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. Copay Required:No Telephone/Verbal Order: No Cosign Required: No Completed b~ .... :b_){ 6 _>; (-b)(- 7 )-(c _> ___ ...,IMD on 07/07/2019 00:30 Generated 07/07/2019 00:30 bfblf5): lb)(7)(Cl Bureau of Prisons - NYM 76318-054 NYM E06 Priority Routine Priority Routine Priority Routine Page 1 of 1

Page 2576 Bureau of Prisons Health Services Health Screen Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/06/2019 21 :38 Provider: Seizures: Diabetes: Cardiovascular: CVA: Hypertension: Respiratory: Sickle Cell Anemia: Carcinoma/Lymphoma: Allergies: PPD Administration: Date/Time: 07/06/2019 21 :39 Provider~(o)(G) ro)(7)(c ) I PA-C Location: Right Forearm Drug Mfg: Sanofi Pasteur Lot Number: C5474BA Dosage: 0.1 ml Route: ID Exp Dt: 10/2020 Comments: Tuberculosis: Hx of Previous Disease: No Blood-tinged Sputum: No Night Sweats: No Weight Loss: No Fever: No Cough:No Comments: Denied Denied Denied Denied Denied Denied Denied Denied Denied M [ 1))(6); (D)(7)(C) Generated 07/06/2019 21 :56 b (b)(G); (b)!7)(C) A-C Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM Page 1 of 6

Page 2577 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/06/2019 21 :38 Provider: "'" (b=,<5,.... >: <"'" b)(7 = i=(c,- ) ---,PA-C Infectious Disease Risk Factors: IV Drug Use: No IV Drug Use Needles: Sexual Partner IV Drug Use: No Sexual Partner IV Drug Use Needles: Female Sexual Partners (Last 5 Yrs): 1 0+ Male Sexual Partners (Last 5 Yrs): O Condom Use: Sometimes Sexual Contact With HIV+ Individual: No Blood Product Transfusion: No Travel Outside US: Yes Tattoos: No Comments: Born in US High school diploma Banker Traveled to Paris x 3 weeks up until arrest No tattoos HIV History: When Tested: Test Result: When Diagnosed AIDS: Last CD4: Comments: Hepatitis: Other Infectious Diseases: Syphilis: Syphilis Last Treatment: Genital Warts: Chlamydia: Gonorrhea: Herpes: Chicken Pox: Other: 2019 Negative Denied No N/A No Yes No No Yes No Comments: Chlamydia in 2015, treated Chicken pox in childhood Abuse History: Denied Physical: No Emotional: No Sexual: No Comments: Denies Generated 07/06/2019 21 :56 by (b;(5>; (b)(?)(C) PA-C Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM Page 2 of 6

Page 2578 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M ,..,..,.,..,~~~~ Encounter Date: 07/06/2019 21 :38 Provider: (bl<61; (b)<7>cc, Mental Health: Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Hx of Mental Health Treatment: None Hx of Head Injury: None Current Mental Health Treatment: No Current Mental Health Complaint: No Hx of Loss of Consciousness: No Hx of Hearing Voices: No Past History of Suicide Attempt: No Current Suicide Ideation: No Suicide Prevention lnitiated:No Comments: Substance Use History: Denied Current Painful Condition: Denied Other Health Issues: Current Medical Conditions: Other Current Treatments: Pregnant: N/A Dental Condition: Denied Generated 07/06/2019 21 :56 b ~ ,bl(6>; (bl(?i(C) IPA-C Bureau of Prisons - NYM Reg#: Race: PA-C Facility: 76318-054 WHITE NYM Page 3 of 6

Page 2579 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/06/2019 21 :38 Provider: r ~= )(5~): (~b)(7= )c=c )---,f A-C Observations: Draining Skin Lesions: No Signs of Lice: No Signs of Scabies: No Signs of Recent Trauma: No Recent Tattoos: No Needle Marks: No Signs of Rash: No Open Sores: No Wounds: No Body Deformities: No Tremors: No Sweating: No Comments: Pulse: ~ Time 07/06/2019 21 :43 Rate Per Minute Location Via Machine Rhythm Respirations: ~ 07/06/2019 Blood Pressure: Iime 21:43 NYM Date Time Value 90 Rate Per Minute Provider 15 b:(6); (b)(7i(C) PA-C Cuff Size Reg#: Race: Facility: Provider 07/06/2019 21 :45 NYM 164/90 07/06/2019 21 :43 NYM 155/83 Location Right Arm Left Arm Position Sitting Sitting Adult-regular b)<5>: (b>cncc> Adult-regular SaO2: a.are. Iime Value(%) Air Provider 07/06/2019 21 :43 NYM 95 Room Air b)(6i: (b)(7)(C) PA-C Height: Date Iime Inches 07/06/2019 21 :43 NYM 72.0 Weight: Date Time Lbs 07/06/2019 21 :43 NYM 200.0 Prosthetic Devices/Equipment: Denied Potential Items For Follow-up: ~ Travel Outside US Other Infectious Disease History Comments: .cm Provider 182.9 .b)(6); (b)(7)(C) Kg Waist Circum. 90.7 I have reviewed O pages of intake paperworks PA-C Provider (b)(6); (b)(7)(C) Generated 07/06/2019 21 :56 b ~ b)C5>; (b)(7)(C) f A-C Bureau of Prisons - NYM PA-C 76318-054 WHITE NYM PA-C Page 4 of 6

Page 2580 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/06/2019 21 :38 Provider: ~jtb-l(6->: (-b~-7>(-c>-~IPA-C Health Problems Newly Identified During This Encounter: Health Problem Medication Reconciliation. Reg#: Race: Facility: 76318-054 WHITE NYM The patient's known medication list including OTC items was compiled and compared to new and changed BOP orders. Reconciled Medications: Source Action ~ Rx# OTC Medication Order Detail New Laboratory Requests: Details Lab Tests-H-Hemoglobin A1C Lab Tests-C-CBC w/diff Lab Tests-L-Lipid Profile Lab Tests-C-Comprehensive Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Reflex to Microscopic Additional Information: 66 y/o male, elevated BP No known OTCs Frequency One Time Labs requested to be reviewed by: l ..... :bX_6_l;(-blC_n_cc_> ___ __.IMO New Non-Medication Orders: Order Frequency Duration Details EKG One Time 66 y/o male Order Date: 07/06/2019 Due Date 08/05/2019 00:00 Fecal Occult Blood One Time Order Date: 3 different stools Schedule: Activity Vision Screen 66 y/o male PPD Reading Follow-up BP check Other: BP noticed to be elevated. 07/06/2019 Date Scheduled Scheduled Provider 07/06/2019 00:00 Optometrist 07/08/2019 00:00 Nurse 07/09/2019 00:00 Mid-Level Provider IM denies Hx of HTN or any significant chronic medical conditions. He is currently asymptomatic and denies any bodily complaints at this time. Will recheck BP in 2-3 days. Disposition: Follow-up at Sick Call as Needed To be Evaluated by Provider Instructed inmate how to obtain medical, dental, and mental health care. Copay Required:No Telephone/Verbal Order: No Generated 07/06/2019 21 :56 bt bH6l: (b)(l )(C) f A-C Cosign Required: Yes Bureau of Prisons - NYM Priority Routine Ordered By (b)(6j; (b)(7)(C) PA-C PA-C Page 5 of 6

Page 2581 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/06/2019 21:38 Provider: """fb=l(5,....>:(,,...,b)(7=)=(c.,....> --,IPA-C Completed bytb><5>: (b)C?xc> p A-Con 07/06/2019 21 :56 Requested to be cosigned by (-b:<5); Cb)(?)(Cl I MD. Cosign documentation will be displayed on the following page. Generated 07/06/2019 21 :56 b bJ(6); (bJC7J(C) PA-C Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM Page 6 of 6

Page 2582 Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01 /20/1953 Sex: M Encounter Date: 07/06/2019 21 :38 Provider: (b)(6); (b)(7)(C) PA-C Cosigned with New Encounter Note b~L..·b_>1s_);{_o:c_nc_c> ___ ____,IMD on 07/07/2019 00:17. Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM

Page 2583 Bureau of Prisons Health Services History & Physical Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/09/2019 12:35 Seizures: Diabetes: Cardiovascular: CVA: Hypertension: Respiratory: Sickle Cell Anemia: Carcinoma/Lymphoma: Allergies: Tuberculosis: Hx of Previous Disease: No Blood-tinged Sputum: No Night Sweats: No Weight Loss: No Fever: No Cough:No Comments: Infectious Disease Risk Factors: IV Drug Use: No IV Drug Use Needles: Denied Denied Denied Denied Denied Denied Denied Denied Denied Sexual Partner IV Drug Use: No Sexual Partner IV Drug Use Needles: Female Sexual Partners (last 5 Yrs): 10+ Male Sexual Partners (Last 5 Yrs): o Condom Use: Sometimes Sexual Contact With HIV+ Individual: No Blood Product Transfusion: No Travel Outside US: Yes Tattoos: No Comments: Born in US High school diploma Banker Sex: M Race: WHITE Provider: l(bl<5>; tbl<7><c , ~ LP Traveled to Paris x 3 weeks up until arrest No tattoos Generated 07/09/2019 13:03 b ~ b)t5>: (b;[7J(C) I MLP Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Page 1 of 13

Page 2584 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: HIV History: When Tested: Test Result: When Diagnosed AIDS: Last CD4: Comments: Hepatitis: Other Infectious Diseases: Syphilis: Syphilis Last Treatment: Genital Warts: Chlamydia: Gonorrhea: Herpes: Chicken Pox: Other: 2019 Negative Denied No N/A No Yes No No Yes No Comments: Chlamydia in 2015, treated Chicken pox in childhood Abuse History: Denied Physical: No Emotional: No Sexual: No Comments: Denies M Race: WHITE 'b)(6); (bi(7)(C) MLP Generated 07/09/2019 13:03 by (bl<5>: <b)(7)(C> LP Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Page 2 of 13

Page 2585 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/09/2019 12:35 Mental Health: Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Hx of Mental Health Treatment: None Hx of Head Injury: None Current Mental Health Treatment: No Current Mental Health Complaint: No Hx of Loss of Consciousness: No Hx of Hearing Voices: No Past History of Suicide Attempt: No Current Suicide Ideation: No Suicide Prevention lnitiated:No Comments: Substance Use History: Denied Current Painful Condition: Denied Other Health Issues: Current Medical Conditions: Other Current Treatments: Pregnant: NIA Dental Condition: Denied Generated 07/09/2019 13:03 b fblt6i:<b)(?)CC) MLP Reg#: Sex: M Race: WHITE Provider: lfbX6>; lb)(7l(C) I MLP Facility: Unit: Bureau of Prisons - NYM 76318-054 NYM H01 Page 3 of 13

Page 2586 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: Observations: Draining Skin Lesions: No Signs of Lice: No Signs of Scabies: No Signs of Recent Trauma: No Recent Tattoos: No Needle Marks: No Signs of Rash: No Open Sores: No Wounds: No Body Deformities: No Tremors: No Sweating: No Comments: M Race: WHITE (b)(6); (b)(7)(C) MLP Generated 07/09/2019 13:03 b ~ bl(G); (b){?)(C) IMLP Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Page 4 of 13

Page 2587 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: M Race: WHITE (b)(6): (b~7)(C) MLP Facility: Unit: Immunizations: Hepatitis A and B (TwinRx) Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Providert lC5l: (b}(?)CC> ~ LP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Measles/Mumps/Rubella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider :b>C5>: (bKncc> MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: (b)<6>: (b)(ntc > MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Tetanus Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Generated 07/09/2019 13:03 bf blt5>;(b)(7)(C) ~ LP Bureau of Prisons - NYM 76318-054 NYM H01 Page 5 of 13

Page 2588 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: b)(6); (b){7){C) MLP Immunization Date: Provider: (bl<5>; <bJ(7J<c ) MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Varicella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: (b)(6); (b)(7)(C) Provider .__ ___ ..... MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Time Fahrenheit Celsius Location Provider Reg#: Facility: Unit: Temperature: ~ 07/09/2019 12:49 NYM 97.3 36.3 Oral 'b)(6); (b)(7)(C) MLP Pulse: ~ Tum 07/09/2019 12:49 Respirations: Rate Per Minute 82 Location Via Machine Rhythm Regular Date 07/09/2019 Time Rate Per Minute Provider 12:49 NYM 16jtb)(6); (b){7)(C> I MLP Blood Pressure: Date Time Value Cuff Size Provider b)(6}: (b)(7)(C) Provider 76318-054 NYM H01 . MLP 07/09/2019 12:49 NYM 117/66 Location Right Arm Position Sitting Adult-regular f b)(5); (b){7){C) r- MLP Sa02: ~ Time Value(%) Air Provider 07/09/2019 12:49 NYM 97 Room Air r b)(6): (b)(7){C) IMLP Height: ~ Time 07/09/2019 12:49 NYM Inches 70.0 Generated 07/09/2019 13:03 b (bll6i:<b)(l )CCJ MLP .cm Provider 177.8 (b)(5); (b)(l )(C) MLP Bureau of Prisons - NYM Page 6 of 13

Page 2589 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: (b)(6);(b)(7)(C) MLP .o.ate. Time Inches Weight: .o.ate. Time .!..hs. 07/09/2019 12:49 NYM 194.4 Prosthetic Devices/Equipment: Denied Tobacco Usage: Denied General Social History: Foreign Travel: Born in USA: Yes Country of Birth: USA Patient Education Assessments: .cm PrQvider Ksl Waist Circum. PrQvider 88.2 ! b)(6); (b)(7)(C) IMLP Reg#: Facility: Unit: 76318-054 NYM H01 .o.ate. Ed Yrs OccupatiQn Learns Best By Primary Language Barriers tQ EducatiQn 07/09/2019 12 Banker Family History - Father: Age at Death: 7 4 Cause of Death: Diabetes complications Significant Illnesses: Diabetes Heart Disease Comments: Family History - Mother: Age at Death: 81 Cause of Death: Kidney Failure Significant Illnesses: Heart Disease Comments: Family History - Sibling: Number of Siblings: 1 Significant Illnesses: Comments: Past Hospitalization: ReasQn Acute Appendicitis Complications: None Comments: Head: Normal: Yes Comments: Generated 07/09/2019 13:03 by (b)(ij); (b)(l )(C) MLP Speaking/Listening English None LQcatiQn Mount Sinai Hospital Bureau of Prisons - NYM When 1990 Page 7 of 13

Page 2590 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/09/2019 12:35 Eyes: EOMI: Yes lcterus:No Conjunctiva! Inflammation: No Pupils PEARLA: Yes Pupil Size Rt: Pupil Size Lt: Pupils Comments: Fundi Vessels Nicking: No Fundi Vessels Discs Flat:Yes Fundi Vessels Discs Sharp Margins: Yes Fundi Vessels Grounds Abnormal: No Eyes Comments: Vision Screen Blindness: 07/09/2019 12:52 Distance Vision: OD: 100 Near Vision: OD: Ishihara Color Test: Tonometry: L: R: OS: 70 OS: Reg#: Sex: M Race: WHITE Provider: r )(6); (bX?)(C) ~ LP Facility: Unit: With Corrective OU: OD: OU: OD: OS OS: Comments: Needs evaluation with optometrist. Ears: Right Ear: Canal patent Left Ear: Canal patent Ears Comments: Nose: Nares Patent: Yes Septum Midline:Yes Septum Intact: Yes Drainage/Discharge: No Polyps: No Nose Comments: Generated 07/09/2019 13:03 by (b)(5); (b)(?)(C) MLP Bureau of Prisons - NYM 76318-054 NYM H01 OU: OU: Page 8 of 13

Page 2591 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/09/2019 12:35 Mouth Lesions: No Oral/Buccal Mucosa:Yes Gums Normal: Yes Tonsils Present:Yes Tonsils Normal: Yes Pharynx: Normal Color Teeth Poor Dentition: No Teeth Count:Mostly Present Dentures: No Mouth Comments: Cranial Nerves: Intact II-XII: Yes Cranial Nerves Comments: Neck: Full ROM: Yes Masses/Nodes: No Trachea: Midline Thyroid: Normal Size Comments: Breasts: Normal:Yes Masses: No Tenderness: No Scars: No Dimpling:No Nipple Discharge: No Nipple Retraction:No Instructions for Self Breast Exam Given: No Comments: Sex: M Race: WHITE Provider: r b~6): (b)(l )(C) I MLP Generated 07/09/2019 13:03 b 'b)(5): (b)(7)(C) MLP Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Page 9 of 13

Page 2592 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/09/2019 12:35 Thorax: Contour Normal:Yes Increased AP Diameter: No Asymmetrical Expansion: No Lungs Clear: Yes Wheezes: No Crackles: No Rhonchi: No Rales: No Accessory Muscle Use: No Comments: Spine: Deformity: No Full ROM:Yes Tenderness: No Comments: Cardiovascular: RRR: Yes Normal S1/S2: Yes Murmurs: No Carotid Bruits: No JVD: No Arteries: Radial: Femoral: Dorsalis Pedis: Post. Tibialis: Comments: Right Generated 07/09/2019 13:03 b ~ b/(5): (b)(7)(Cl IMLP Reg#: Sex: M Race: WHITE Provider: (b/(6> (b)aHc, MLP Facility: Unit: Bureau of Prisons - NYM 76318-054 NYM H01 Page 10 of 13

Page 2593 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: Abdomen: Normal Contour:Yes Scaphoid: No Obese: No Gravid: No Hernias: No Bruits: No Masses: No Scars: No Tenderness: No Organomegaly: No Active Bowel Sounds: Yes Comments: Extremities: Nails Clubbing: No Nails Cyanosis: No Lower Extremity Edema - Right: None Lower Extremity Edema - Left: None Atrophy: No Amputations: No Other Deformities: No Varicosities:No Calf Tenderness: No Pulse Deficit: No Strength: Arm: Leg: Full ROM: Arm: Leg: Comments: Bight .Bight Yes Yes .Lett .Left Yes Yes M Race: WHITE (b)(6); (b)(7)(C) MLP Generated 07/09/2019 13:03 bi tbH6l: tb)(7)(c) ~ LP Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Page 11 of 13

Page 2594 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: Reflexes: Biceps: Patellar: Brachioradialis: Achilles: Sensation: Vibratory: Yes Light Touch: Yes Pin Prick: Yes Comments: GU: Chaperoned By: Rectum: Not Done Comments: Refused. Male Genitalia: Not Done Comments: Refused. Skin: Normal:Yes Rash:No Redness:No Right Left Abnormal Pigmentation: No Abnormal Lesions/Growths: No Comments: Lymphatics: Adenopathy: No Comments: Potential Items For Follow-up: Item Travel Outside US Other Infectious Disease History Rectum Not Done Male Genitalia Not Done PPD Administration Not Performed Comments: Patient has a history of constipation. M Race: WHITE b)(6); (b)(7)(C) MLP Generated 07/09/2019 13:03 by (b)(5); (b)(7)(C: MLP Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Page 12 of 13

Page 2595 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: CbK5>: Cb)(7lCC) LP Cleared For Food Services: Yes Health Problems Newly Identified During This Encounter: Health Problem Constipation, unspecified - Current - New Medication Orders: Rx# Medication Bisacodyl E.C. Tablet Indication: Constipation, unspecified Disposition: Follow-up at Sick Call as Needed Order Date 07/09/2019 12:35 Instructed inmate how to obtain medical, dental, and mental health care. Copay Required: No Telephone/Verbal Order: No Cosign Required: Yes Completed byltb)(B) Cb)(7;(c) I MLP on 07/09/2019 13:03 Requested to be cosigned by r :(5) (b)(?)(C; IMD. Cosign documentation will be displayed on the following page. Generated 07/09/2019 13:03 by (b;C5l: (b)C7i(C) LP Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Prescriber Order 5 mg Orally at bedtime PRN x 10 day(s) Page 13 of 13

Page 2596 Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01 /20/1953 Sex: M Encounter Date: 07/09/2019 12:35 Provider: 'b}(6i: (b)(7XC) Cosigned b ~.__ .b;-c5J-;<b_)c_ 7)c_q ___ ___.lMD on 07/11/2019 22:41. Bureau of Prisons - NYM Reg#: Race: MLP Facility: 76318-054 WHITE NYM

Page 2597 Bureau of Prisons Health Services Vitals All End Date: 07/30/2019 Begin Date: 07/02/2019 Reg#: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Temperature: Date 07/24/2019 Time 13:12 NYM Fahrenheit Celsius Location 97.8 36.6 Oral Orig Entered: 07/24/2019 13:14 EST bJ(GJ; Cbl(7J<c > MLP 07/23/2019 06:30 NYM 97.5 36.4 Oral Orig Entered: 07/23/2019 08:33 EST (b><5>: <bl<7 ><c > MLP 07/09/2019 12:49 NYM 97.3 36.3 Oral Orig Entered: 07/09/2019 12:51 EST lblC5i; CbJ(7)icJ MLP Pulse: Provider (b)l6): {b)(7)(C) MLP MLP MLP Date Time 07/30/2019 13:02 Rate Per Minute 94 Location Rhythm Provider Orig Entered: 07/30/2019 13 :04 EST ~r b)-( 5_>; (-b)(-?)-(C-) ---~~ D 07/30/2019 09:40 88 Via Machine Orig Entered: 07/30/2019 13 :04 EST l(b)CG>; (blm cc ) IM D 07/30/2019 09:30 87 Via Machine Orig Entered: 07/30/2019 12:59 EST r b)(6); (b)(7)(C ) I MD 07/28/2019 20:28 81 ~----~ Orig Entered: 07/28/2019 20:29 EST r )(G); (b)(?)(C ) I RN 07/28/2019 06:57 82 Orig Entered: 07/28/2019 06 :58 EST llbJ<6>: lblt7 J<c > IRN 07/24/2019 13:12 83 Via Machine Regular Orig Entered: 07/24/2019 13:14 EST f b)(GJ; (bl<7 Jcc > ~ LP 07/23/2019 06:30 92 Via Machine Regular Orig Entered: 07/23/2019 08:33 EST f blC6>; (b)(7lcc i ~ LP 07/09/2019 12:49 82 Via Machine Regular Orig Entered: 07/09/2019 12:51 EST l(bJl6>: lb)c1icc> r-,,1LP 07/06/2019 21 :43 90 Via Machine Orig Entered: 07/06/2019 21 :48 EST !b/16): (b)(7)(C) Respirations: Date 07/30/2019 Time 09:30 NYM Rate Per Minute Provider 12 l(b)(6); (b)(7)(C) A-C IMD Orig Entered: 07/30/2019 12:59 EST bll6l;(bJC7l<C > MD ~__,,,.===--~-, 07/28/2019 20:28 NYM 14 'b)(6): lb~? )(C) RN Orig Entered: 07/28/2019 20:29 EST <bl(6>: <bll7Jcc > '----'=~=----L.---, 07/28/2019 06:57 NYM 14 b)(6); (b)(?)(C ) RN RN Orig Entered: 07/28/2019 06:58 EST (bJ(5>: tbll7JcC) l---t::==,,,,,_,---,.-.1 07/23/2019 06:30 NYM 16 'b)(6) (b)(7)(C ) RN MLP Orig Entered: 07/23/2019 08:33 EST (bJC6>: lbh? J<c> MLP 07/09/2019 12:49 NYM 16 b)(G) (b)(7)(C) . MLP Generated 07/30/2019 15:33 by r b)(6); (b)(?)(C ) ~OIA Bureau of Prisons - NYM 'b)(6); (b)(7)(C) b)(6); lb)(7)(C) (b)(6); (b)(7)(C) 'b:(6); (b)(7)(C) MD MD MD N N MLP MLP MLP PA-C Page 1 of 3

Page 2598 Begin Date: 07/02/2019 Reg #: 76318-054 End Date: 07/30/2019 Inmate Name: EPSTEIN, JEFFREY EDWARD Date Time Rate Per Minute Provider Orig Entered: 07/09/2019 12:51 EST b)(6);(b)(7)(C) MLP 07/06/2019 21:43 NYM 15 (b)(6); (b)(7)(C) PA-C Orig Entered: 07/06/2019 21 :48 EST b)(6); (b)(7)(C) A-C Blood Pressure: ~ Iim.e. ~ Location Position Cuff Size Provider 07/30/2019 13:02 NYM 114/84 Left Arm Standing Orig Entered: 07/30/2019 13 :04 EST .... r_ )(S-);(-b)-(7i_cc_: ___ _,IM D b)(6i; (b)(7)(C) 07/30/2019 09:40 NYM 125/60 Right Arm Standing Orig Entered: 07/30/2019 13:04 EST b)(S); (b)C7)<C) MD 07/30/2019 09:30 NYM 108/86 Left Arm Orig Entered: 07/30/2019 12:59 EST MD 07/28/2019 20:28 NYM 157/91 (b)(6); (b){7)(C) Orig Entered: 07/28/2019 20:29 EST f~b►_ cs)- ;(b- )(7-)(- c)---~ ~N 07/28/2019 06:57 NYM 138/80 Orig Entered: 07/28/2019 06:58 EST .... r _)(S-);(-=b)(7,..,..)(....,.C)---~ 07/24/2019 13:12 NYM 132/89 Right Arm Sitting r :dult-regular b)(S); (b)(?)(C) Orig Entered: 07/24/2019 13:14 EST fblt5>; Cbl(7)(Cl IMLP 07/23/2019 06:30 NYM 140/85 Right Arm Sitting Adult-regular Orig Entered: 07/23/2019 08:33 EST b)(S);(b;{?)cc> MLP 07/09/2019 12:49 NYM 117/66 Right Arm Sitting Adult-regular Orig Entered: 07/09/2019 12 :51 EST [ b)(s}; Cb)C7>cc> IMLP 07/06/2019 21 :45 NYM 164/90 Right Arm Sitting Adult-regular (b)(6); (b)(7)(C) Orig Entered: 07/06/2019 21 :48 EST !1bi(5>: (b){7><C> IPA-C 07/06/2019 21 :43 NYM 155/83 Left Arm Sitting Adult-regular Orig Entered: 07/06/2019 21 :48 EST f b;cs>; (b)(7►cc) f A-C SaO2: Date Time Value(%) Air Provider 07/30/2019 09:30 NYM 98 Room Air --~----===.--- O rig Entered: 07/30/2019 12 :59 EST l1b)CS); lbJC7Jcc> ~-----;;;=;=,;==;-'=- 07/28/2019 20:28 NYM 98 f b)(6); (b)(7)(C) I MD ~ D rb)(6); (b)(7)(C) jh RN Orig Entered: 07/28/2019 20:29 EST 07/28/2019 06:57 NYM 98 '------,.,,.,.,,,,...,,.,.,.,~- b)(6); ib)(7)(C) RN (b)(6); (b)(7)(C) RN Orig Entered: 07/28/2019 06:58 EST 'bKs>; (b)f7)<c) ~-----!!"'=-,,,-,-- 07/24/2019 13:12 NYM 96 Room Air RN b)(6); (b){7)(C) MLP Orig Entered: 07/24/2019 13: 14 EST f b)(s>; (bJf7><Cl 07/23/2019 06:30 NYM 96 Room Air Orig Entered: 07/23/2019 08 :33 EST f b)(s); Cb:mcc> -----~---- 07/09/2019 12:49 NYM 97 Room Air Orig Entered: 07/09/2019 12:51 EST ,.,. ,cb=)cs.,...J;c""'"bl=(7>""' cc.,...> --,L---- 07/06/2019 21 :43 NYM 95 Room Air ~ LP jMLP !b)(6); (b)(7)(C) IMLP [b)(6); ib)(7)(C) ~ LP IMLP l(b)(6); (b}(7)(C) I PA-C Orig Entered: 07/06/2019 21 :48 EST ICb)ts>; Cb><7>cc> I PA-C Height: Generated 07/30/2019 15:33 b~Cb)(S); (b)(?)CCJ f OIA Bureau of Prisons - NYM MD MD MD RN RN MLP MLP MLP PA-C PA-C Page 2 of 3

Page 2599 Begin Date: 07/02/2019 Reg #: 76318-054 End Date: 07/30/2019 Inmate Name: EPSTEIN, JEFFREY EDWARD Date Time Inches Cm Provider 07/09/2019 12:49 NYM 70.0 177.8 "b)(6); (b)(7)[C) . MLP Orig Entered: 07/09/2019 12:51 EST (b)(6); [b)(?)rc> MLP 07/06/2019 21 :43 NYM 72.0 182.9 (b)(6); (b)(?)(C) PA-C Orig Entered: 07/06/2019 21 :48 EST b)(6); (b)(?)(C) PA-C Weight: Date 07/30/2019 Ii.me. 09:30 NYM Lbs 194.2 Kg Waist Circum. Provider 88.1 1:b)(6); (b)(7)(C) I MD ~....,,..,..,,,,,.,-,,--___:= :::;-----~ Orig Entered: 07/30/2019 12:59 EST ( b)(fi>; <bl<7>tc > I MD ~------;:::::::::::'.. __ ~ 07/09/2019 12:49 NYM 194.4 88.2 r b)(fi) [b)[7)(C) 1 MLP Orig Entered: 07/09/2019 12:51 EST (bX6>;<b>mrc> LP 07/06/2019 21 :43 NYM 200.0 90.7 r= b)=[6)....,. ; [b-= )[7=),c,.,.... ) --, 1 pA-C Orig Entered: 07/06/2019 21 :48 EST r )(6); (b)(7)(C) p PA-C Generated 07/30/2019 15:33 ~ bl(6>; (b:f7lfC) IFOIA Bureau of Prisons - NYM Page 3 of 3

Page 2600 Bureau of Prisons Health Services PPDs Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Admin: Location Pro:llidec Reading: Indy ration Provider 07/06/2019 21 :39 Right Forearm ! b)(6): (b}(7)(C) f A-C 07/09/2019 12:47 0 mm [ b)(6); (b)(7)(C) Orig Entered: 07/06/2019 21 :43 EST (bj(6); (b)(7)(C) PA-C Orig Entered: 07/09/2019 12:47 EST 'b)(6) (b)(7)(C ) Total: 1 Generated 07/30/2019 15:33 b / bl(G); (b)(l )(C) OIA Coordinator Bureau of Prisons • NYM IMLP LP Page 1 of 1

Page 2601 76318-054 Ord. Date 07/30/19 14:21 Exp. Date 08/06/ 19 14:20 NYM 122148- NYM Providers: EPSTEIN, JEFFREY Medication Orders ( b)(6); (b)(7)(C ) Inject regular insulin subcutaneously per sliding scale: twice daily ... pill llne* .. for 7 days Insulin Reg (10 ML) 100 UNITS/ML lnj Documentation Codes: ORD = Order Medication Administration Record JULY 2019 Time 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 IMD PRN Registration #: 76318-054 Pt. Name: EPSTEIN, JEFFREY DOB: 01/20/53 Report information is current as of the date and time of printing: 07/30/2019 15:33 EST

Page 2602 Start Date: 07/02/2019 Reg#: 76318-054 Bureau of Prisons Health Services Devices and Equipment Stop Date: 07/30/2019 Inmate Name: EPSTEIN, JEFFREY EDWARD Device/Equipment start Date stop Date Date Returned Obtained From Comments C-Pap 07/30/2019 14:05 ESTf ..... ·b)_( 6 )_; (b- )(7- )(C_ ) ___ _,IMD 07/30/2019 Total: 1 Generated 07/30/2019 15:33 by (b)(5); (b)(?)(C) OIA Coordinator Bureau of Prisons - NYM Personal PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL#: P11312813B1ED. Page 1 of 1

Page 2603 Begin Date: Reg#: ~ 07/02/2019 76318-054 Intervention 07/12/2019 13:25 MEDROL DOSE PACK Bureau of Prisons Health Services Pain Management Pain Quality Shooting Orig Entered: 07/12/2019 13:28 EST ~rx_ 6 _); (-o)(7_ )-(C-) ---~~ D Generated 07/30/2019 15:33 b { b)(6); (o)(?)(C) to1A Coordinator Bureau of Prisons • NYM End Date: 07/30/2019 Inmate Name: EPSTEIN, JEFFREY EDWARD Location Pre fQ.fil Provider Back-Middle 5 l~' 0 _)' 5_>;<_ 0 )_c 1 >_cc _> ---~IMD Page 1 of 1

Page 2604 Types of Diets: _ Clear Liquid Low Fat Mechanical Soft Low Cholesterol _ Low Triglyceride Renal _ Full Liquid Sodium Controlled Snack Diabetic Calorie Controlled X Other: FISH ALLERGIES. Comments: EPSTEIN, JEFFREY EDWARD Inmate Name Generated 07/30/2019 14:57 b~b)(6l (b)[7)(C) Bureau of Prisons Health Services Modified Diet Request IMD 76318-054 Reg# Bureau of Prisons - NYM Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: 07/30/2020 r b)(6); (b)(?)(C) , MD Health Service Staff 07/30/2019 Date Page 1 of 1

Page 2605 Reg#: 76318-054 Bureau of Prisons Health Services Allergies Inmate Name: EPSTEIN, JEFFREY EDWARD Allergy Date Noted Reaction No Known Allergies 07/06/2019 Orig Entered: 07/06/2019 21 :40 EST (bl(5>: CbiC7lCCJ A-C Total: 1 Generated 07/30/201915:33 b f bHBJ; (b)(7)(C) IFOIA Bureau of Prisons - NYM Page 1 of 1

Page 2606 Bureau of Prisons Health Services Patient Education Assessments & Topics Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Assessments Assessment Learns Best By Primary Language Years of Education Barriers To Education 07/09/2019 Speaking/Listening English 12 Total: 1 ib)(6); (b)(7)(C) Orig Entered: 07/09/2019 12 :52 EST Date Initiated Format Handout/Topic 07/30/2019 Counseling Access to Care Orig Entered: 07/30/2019 13:33 EST ~r- )(6-);(-b)-(l)-(C-) ----~ 07/30/2019 Counseling Plan of Care Orig Entered: 07/30/2019 13:34 EST ~r -)(6-);(-b)(7=)~(C-) -------, 07/28/2019 Counseling Plan of Care 07/28/2019 Orig Entered: 07/28/2019 20:30 EST ..,...rb)=(5,-);(,,..,.b)(=7)=(c,-) -----, Counseling Plan o~ care Orig Entered: 07/28/2019 07:22 EST"'"r=)(6,,...);..,...,(b)(""'l"" )(C,,....)-----, 07/24/2019 Counseling Preventive Health Orig Entered: 07/24/2019 13:23 EST rbi(5) (b)(7)(C) 07/24/2019 Counseling Access to Care Orig Entered: 07/24/2019 13:23 Esi b)(6) (b)(l )(C) 07/23/2019 Counseling Plan of Care ""(b)(""'6),-,; (b,..,.,)(7"")(=C)---, Orig Entered: 07/23/2019 09:04 EST 07/23/2019 Counseling Access to Care Orig Entered: 07/23/2019 09:04 EST r )(5);(bi(7)(C) 07/14/2019 Counseling Diagnosis ""r'b,,..,,)(6,.,...);,,,..(b)""(7,..,.,)(C,..,.)------, Orig Entered: 07/14/201918:11 EST .,_ ______ ___. 07/12/2019 Counseling Diagnosis None Topics Generated 07/30/2019 15:33 by r )(5); (b)(7)(C) IFOIA Coordinator Bureau of Prisons • NYM Outcome Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Provider rb)(6); (b)(7)(C) Provider b)(6); (b)(7)(C) b)(6); (b)(7)(C) (b)(6); lb)(7)1C) (b)(6); (b)(7)(C) Page 1 of 2

Page 2607 Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Topics Date Initiated Format Handout/Topic Outcome Provider Orig Entered: 07/1 2/2019 13:33 EST r~b)-(B-);(-b){7 _ )(_C_) ----~ Total: 10 Generated 07/30/2019 15:33 ~ b)(e); (b)(?)(C) r OIA Coordinator Bureau of Prisons • NYM Page 2 of 2

Page 2608 Bureau of Prisons Health Services Health Problems Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Description Hyperlipidemia, unspecified 07/12/2019 13:48 EST r""':b)=(5)...,., ; (b""")r7=xc=)----,~ D HYPERTRIGL YCERIDEMIA Sleep apnea 07/12/2019 13:56 ESTrb)(G); (b}(7)(C) ~ D Essential (primary) hypertension 07/30/2019 13:13 ES~ (b)(6);(b)(7)(C) IMD BYHX. Constipation, unspecified =....,,..,....,,,.,.,..,...---, 07/09/2019 12:58 EST :b)(6); (b)(?)(C) MLP Low back pain 07/12/2019 13 :30 EST!(b)(5); (b)(?)(C) MD Neuralgia and neuritis, unspecified 07/12/2019 13:30 EST'~(b)(- 6)-;(b-Xl-)(-C)---~~ D No Diagnosis 07/09/2019 10:28 ESTlb)(6); (b}(7)(c) !PhD/Chief Psychologist Prediabetes 07/30/2019 13:26 EST r )(G); (b)(7)(C) 1 MD Injury, unspecified 07/23/2019 09:04 EST :b)(G) (b)(?)(C) MLP R/O self inflicted injuries. Body mass index (BMI) 27.0-27.9, adult 07/30/201913:14 ESTr )(5)(b)(7)(C) 1 MD Total: 10 Generated 07/30/2019 15:33 bl(b)(G); (b)(?)(C) p 1A Coordinator &is. Code Type Current ICD-10 ICD-10 ICD-10 ICD-10 ICD-10 ICD-10 I DSM-IV ICD-10 ICD-10 ICD-10 Bureau of Prisons • NYM .G.od.e. Di ag. Date Stah!s. Status Date E785 07/12/2019 Current G4730 07/12/2019 Current 110 07/30/2019 Current K5900 07/09/2019 Current M545 07/12/2019 Current M792 07/12/2019 Current No Dx 07/09/2019 Current R7303 07/30/2019 Current T1490 07/23/2019 Current 26827 07/30/2019 Current Page 1 of 1

Page 2609 Bureau of Prisons Health Services Vision Screens Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Vision Screen on 07/09/2019 12:52 Blindness: Distance Vision: OD: 20/100 Near Vision: OD: With Corrective Distance Vision: OD: Near Vision: OD: OS: 20/70 OS: OS: OS: Present Glasses - Distance Refraction - Distance Sphere Cylinder Axis Add Sphere Cylinder R: R: L: L: Color Test: Tonometry: R: L: Comments: Needs evaluation with optometrist. Orig Ent ered: 07/09/2019 12:54 EST ..,.. rb= )(B.,- ); (,,..,.b)(7 = }=(c ,.... ) -,I MLP Generated 07/30/2019 15:33 b~b)(BI; (bi(?)(C) jFOIA Bureau of Prisons - NYM OU: OU: OU: OU: Axis Add Page 1 of 1

Page 2610 Bureau of Prisons Health Services Immunizations Begin Date: 07/02/2019 Reg #: 76318-054 End Date: 07/30/2019 Inmate Name: EPSTEIN, JEFFREY EDWARD Immunization Immunization Date Administered Location Dosage Drug Mfg. Hepatitis A and B (Twin Rx) History Unknown Orig Entered: 07/09/201912:51 EST 1cb,(5):<bl(7>cq jMLP Measles/Mumps/Rubella Series History Unknown Orig Entered: 07/09/2019 12:51 EST l'b)(G>;<bX?)(C) IMLP Smallpox Series History Unknown Orig Entered: 07/09/2019 12:51 ESTl'b)(G>; (b)(7)(c> IMLP Tetanus History Unknown Orig Entered: 07/09/2019 12:51 EST rb:(5); (b)(?)(C) ~ LP Varicella Series History Unknown Orig Entered: 07/09/2019 12:51 EST (b)(G) <b)(7)(C) MLP Total: 5 Generated 07/30/2019 15:33 b { b)(G); (b)(7)(C) p 1A Coordinator Bureau of Prisons • NYM Exp Date Page 1 of 1

Page 2611 ----------------- Burf-.:~ 1 f Prisons Hea.th Services l\j e • cal Duty Status Reg #: 76318-054 t nm ate Name: EPSTEIN, JEFFREY EDWARD Housing Status _ confined to the living quarters except meals _ pill line treatments Exp. Date: _ on complete bed rest: _ bathroom privileges only Exp. Date: ---- - - - - - - - - X cell: _cell on first floor _single cell X lower bunk airborne infection isolation Exp. Date: _ 10,09/2019 other: Exp. Date: - - ---- Physical Limiia.: - 1/Restriction _ all spotts Exp. Date: _____ _ weightlifting: upper body lower body Exp. Date: ------ cardiovascular exercise: _running _jogging _ walking softball Exp. Date: ------ football basketball handball stationary equipment other: Exp. Date: ------ May have the following equipment in his / her possession: Equipment Start D.:\te End Date Return Date C-Pap 07/30i2019 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL#: P1 1312813B1 ED. Work Restriction / Limitation: Cleared for Food Service: Yes --- x No Restrictions Comments: N/A r )(6); (b)[7)(C) 07/30/2019 Health Services Staff Date Inmate Name: __ E_P_S_T_E_I_N""", J_E_F_r_-q_E_Y_E_D_W_A_R_D __ Reg #: __ 7_6_3_18_-_05_4 __ Quarters: __ Z_04 __ ALL EXPIRATION DATES AR£ T 24:00 Generated 07/30/2019 15:33 b~ bl(6): (b)C7HC) jFOIA Elureau of Prisons - NYM Page 1 of 1

Page 2612 ----------------- Burf-.:~ 1 f Prisons Hea.th Services l\j e • cal Duty Status Reg #: 76318-054 t nm ate Name: EPSTEIN, JEFFREY EDWARD Housing Status _ confined to the living quarters except meals _ pill line treatments Exp. Date: _ on complete bed rest: _ bathroom privileges only Exp. Date: ---- - ~ - - - - - - X cell: _cell on first floor _single cell X lower bunk airborne infection isolation Exp. Date: _ 10,09/2019 other: Physical Limiia.: - 1/Restriction _ all spotts weightlifting: upper body lower body cardiovascular exercise: _running _jogging _ walking football basketball handball other: May have the following equipment in his / her possession: Work Restriction / Limitation: Cleared for Food Service: Yes --- x No Restrictions Comments: N/A Health Services Staff Inmate Name: EPSTEIN, JEFFREY EOW D Reg#: _____ ....._ ___ ~-- - - ALL EXPIRATION DA TES ARE AT 2•1:00 Exp. Date: - - ---- Exp. Date: _____ _ Exp. Date: ------ softball Exp. Date: ------ stationary equipment Exp. Date: ------ 07/09/2019 Date 76318-054 Quarters: 204 Generated 07/30/2019 15:33 b 'b)(5); (bi(J )(C) FOIA Elureau of Prisons - NYM Page 1 of 1

Page 2613 Complex: NYM--NEW YORK MCC Inmate: EPSTEIN, JEFFREY EDWARD Bureau of Prisons Health Services Medication Summary Historical Begin Date: 07/02/2019 Reg #: 76318-054 End Date: 07/30/2019 Quarter: Z04-206LAD Medications listed reflect prescribed medications from the begin date to end date on this report. Allergies: Denied Active Prescriptions Bisacodyl E.C. 5 MG TAB Take one tablet (5 MG) by mouth at bedtime AS NEEDED for 10 days Rx#: 121757-NYM Doctor: l(bl(6); {b)C7)<c> I MLP Start: 07/09/19 Exp: 07/19/1 9 O/C: 07/12/19 Pharmacy Dispensings: 10 TAB in 22 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) by mouth twice daily for 30 days Rx#: 121823-NYM Doctor: fb>(5>; (b)(7)(C) I MD Start: 07/12/1 9 Exp: 08/1 1/19 Pharmacy Dispensings: 60 CAP in 19 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) twice daily by mouth with plenty of water Rx#: 122084-NYM Doctorf b)(5J;(b)C7xc> IMD Start: 07/26/1 9 Exp: 01/22/20 Pharmacy Dispensings: 30 CAP in 5 days Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 2 tablespoonful twice daily by mouth Rx#: 121835-NYM Doctor: fb>C5:; (blt7>cc> I MD Start: 07/12/1 9 Exp: 07/14/19 Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 10ml by mouth twice daily AS NEEDED Rx#: 122150-NYM Doctor: r b)(5); (b)(l )(C) !MD Start: 07/30/1 9 Exp: 10/28/19 methylPREDNISolone 4 MG Tab ( 21 count Pack) Take the tablet by mouth as directed Rx#: 121836-NYM Doctor:""fbl,.,.,.<5>,...,; tb,..,..,K7=:c=c>-----,I MD Start: 07/12/19 Exp: 07/18/19 methylPREDNISolone 4 MG Tab ( 21 count Pack) Take the tablet by mouth as directed Rx#: 122149-NYM Doctor:l,.,,.cb>""'<5,.., ); c'""b!<=7>c=c>----,I MD Start: 07/30/19 Exp: 08/05/19 Pharmacy Dispensings: 473 ML in 19 days Pharmacy Dispensings: 473 ML in 1 day Pharmacy Dispensings: 21 tab in 19 days Pharmacy Dispensings: 21 tab in 1 day Generated 07/30/2019 15:33 byl(bi(6) (b)(7)(C) py FOIA Bureau of Prisons - NYM Page 1 of 2

Page 2614 Complex: NYM--NEW YORK MCC Inmate: EPSTEIN, JEFFREY EDWARD Active Prescriptions Omega 3 (Vascepa) 1 GM Capsule Begin Date: 07/02/2019 Reg#: 76318-054 Take two capsules (2 GM) twice daily by mouth with food Rx#: 121885-NYM Doctor: r b)(G) (b)(7)(C) I MD End Date: 07/30/2019 Quarter: Z04-206LAD Start: 07/17/19 Exp: 01 /13/20 Pharmacy Dispensings: 120 Cap in 14 days Insulin Reg (10 ML) 100 UNITS/ML lnj Inject regular insulin subcutaneously per sliding scale: twice daily ***pill line*** for 7 days ***pill line*** Rx#: 122148-NYM Doctor: i<b)(G); <blm(c ) IMO Start: 07/30/19 Exp: 08/06/19 Pharmacy Dispensings: 0 ML in 1 day Generated 07/30/2019 15:33 byf b)(G); (bl(7)CC) I FOIA Bureau of Prisons - NYM Page 2 of 2

Page 2615 Bureau of Prisons Health Services Dental Health History Screen Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/26/2019 07:54 Provider: l1b><6>: lb)(7irc> I DDS Unit: H01 ASSESSMENTS: Health Problems as of Dental Health History Encounter date: 07/26/2019 07:54 Health Problems Health Problem Hyperlipidemia, unspecified HYPERTRIGL YCERIDEMIA Sleep apnea Constipation, unspecified Low back pain Neuralgia and neuritis, unspecified No Diagnosis Injury, unspecified R/O self inflicted injuries. Medical History as of Dental Health History Encounter date: 07/26/2019 07:54 Medical History: Allergies: Denied Seizures: Diabetes: Cardiovascular: CVA: Hypertension: Respiratory: Sickle Cell Anemia: Carcinoma/Lymphoma: HIV History: When Tested: Test Result: When Diagnosed AIDS: Last CD4: Comments: Hepatitis: Denied Denied Denied Denied Denied Denied Denied Denied 2019 Negative Denied Generated 07/26/2019 07:59 b~Cb)C6i: (b){7)IC) joos Bureau of Prisons - NYM Status Current Current Current Current Current Current Current Page 1 of 3

Page 2616 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/26/2019 07:54 Other Infectious Diseases: Syphilis: No Syphilis Last Treatment: NIA Genital Warts: No Chlamydia: Yes Gonorrhea: No Herpes: No Chicken Pox: Yes Other: No Comments: Chlamydia in 2015, treated Chicken pox in childhood Other Health Issues: Sex: M Race: WHITE Provider: f b,(5); (b)<7>(c> I DDS Other Medical Conditions And Treatment: sleep apnea Current Medical Conditions: Other Current Treatments: Pregnant: N/A Dental Observations as of Dental Health History Encounter date: 07/26/2019 07:54 History: Alcohol: No Methamphetamine: No Tobacco products: No Other drugs: No Sensitive teeth: No Bleeding gums: Yes Food impaction: Yes Pain around ear: No Toothache: No Wear partial dentures: No Unusual sounds while eating: No Snoring: Yes Blisters on lips or mouth: No Clenching or grinding: Yes Swelling or lumps in mouth/throat: No Burning tongue: No Bad breath: No Decayed teeth: No Loose teeth: No Wear dentures: No None: No Comments: Generated 07/26/2019 07:59 b ~ b/(6>; (blC7l(Cl I00s Bureau of Prisons - NYM Reg#: 76318-054 Facility: NYM Unit: H01 Page 2 of 3

Page 2617 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/26/2019 07:54 Provider: l(b)(6); (bi(?)(C) IDDS Unit: H01 Cardiac Condition Requiring Prophylaxis: No Prosthetic joint(s): No Radiation history of head or neck: No Excessive bleeding: No Bisphosphonates: No Comments: Medications as of Dental Health History Encounter date: 07/26/2019 07:54 Medications: Docusate Sodium 100 MG Cap Exp: 08/11/2019 SIG: Take one capsule (100 MG) by mouth twice daily for 30 days Omega 3 (Vascepa) 1 GM Capsule Exp: 01 /13/2020 SIG: Take two capsules (2 GM) twice daily by mouth with food OTCs: Listing of all known OTCs this inmate is currently taking. Instructed inmate how to obtain medical, dental, and mental health care. Copay Required: No Telephone/Verbal Order: No Cosign Required: No Completed byllbK5> (b)(7;cc > IDDS on 07/26/2019 07:59 Generated 07/26/2019 07:59 b ~ b/(5): (b)(7)(Cl II DDS Bureau of Prisons - NYM Page 3 of 3

Page 2618 Bureau of Prisons Health Services Dental A&O Exam Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/26/2019 07:47 Provider: (bH5:: (t>X7>,c > OS Reviewed Health Status: Yes Occlusion: Class I Oral Hygiene: Fair CPITN: 3 2 3 3 2 3 Hard and soft tissue examination performed and documented on BP618 form: Yes Head & Neck/Soft Tissue within normal limits? No Comments: moderate to advanced upper posterior gingival recession Decayed: Missing: 0 Filled: 14 Comments: Lower anterior crowding Approved for hygiene appointment and radiographs: Yes Reg#: Facility: Unit: 76318-054 NYM H01 Instructed inmate how to obtain routine and emergency dental care. Oral hygiene instructions given: Yes Dental A&O Screening Exam findings entered on EPSTEIN, JEFFREY EDWARD byr~ ·t>)_r 6 _>:<-b>(7 _ l_(c _) _ _____.IDDS on 07/26/2019 07:47. - · Generated 07/26/2019 08:00 b~(bl(5): Cb)(7J(C) 100s Bureau of Prisons - NYM Page 1 of 1

Page 2619 Bureau of Prisons Health Services Dental Soap/ Adm in Encounter Inmate Name: Date of Birth: EPSTEIN, JEFFREY EDWARD 01/20/1953 Encounter Date: 07/18/2019 13:48 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Sex: ,,...M-~~- R~a=c~e-'-, : WHITE Provider: r b)(G); (b)(7)(C) p ental Asst Reg#: Facility: Unit: 76318-054 NYM Z05 Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed b~~bl_r5_u _b)C-7J_cc_> --~ !Dental Asst on 07/19/2019 13:49. Generated 07/19/2019 13:49 b ~ (b)(G); (b)(?)(C) !Dental Bureau of Prisons • NYM Page 1 of 1

Page 2620 Bureau of Prisons Psychology Services General Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: Date: 01/20/1953 Sex: 07/30/2019 12:01 Provider: ~M~~~-F....;;.;acility: NYM r b)(6;; (b)(7)(C ) psyD Comments Psych Observation Discontinuation Note: Please see "Clinical Contact" dated today. Completed b~(b)(6i: (b)(?)cc> f syD on 07/30/2019 12:33 Generated 07/30/2019 12:33 b lblC6>: (biC7iCCi PsyD Bureau of Prisons - NYM **SENSITIVE BUT UNCLASSIFIED** Reg#: 76318-054 Unit Team: 5 Page 1 of 1

Page 2621 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Institution Disciplinary Process Report Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/30/2019 12:01 Provider: M Facility: NYM ~lrb=)c6~J~ Cb1=a= )1c~i ----,I PsyD Unit Team: 5 Reason for Referral and Identifying Information Inmate Epstein was referred by Unit Manag :~!(~\:.,.,, for an evaluation of competency to proceed with the disciplinary process for actions resulting in an incident report. On 7/23/19, inmate Epstein was charged with code 228 (Tattooing or Self-Mutilation). These infractions were assigned incident report number 3282555. Background Information According to a Suicide Risk Assessment dated 7/09/19 b~(b)C5>: (bl(7KcJ !"Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time." According to a Suicide Risk Assessment dated 7 /09/19 b 1b 1161 lb)miCJ "Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past." b)(7)(A) Clinical Interview and Mental Status Exam b)(7)iA) Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. There was no indication of disturbed thought process or content. Intellectual ability appeared to be above average. Personal hygiene was adequate. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. Clinical Impression According to his last Diagnostic and Care Level Formulation Note dated 7/09/19 b (b)( 6J; (b)i?JtcJ 'No Diagnosis, No Dx - Current." Findings The determination of whether an inmate is competent to proceed with the disciplinary process is based on a clinical assessment of the inmate's (1) ability to understand the nature of the proceedings, and (2) their ability to assist in their own defense. Depending on the outcome of the assessment, one of three findings can be made: (1) the inmate is COMPETENT to proceed with the disciplinary process; (2) the inmate is NOT PRESENTLY COMPETENT but could be restored to competence with treatment; or (3) the inmate is NOT COMPETENT and is unlikely to become competent. Recommendations Regarding Sanctions In the case of inmate Epstein, after a review of available psychological and psychiatric records as well as information pertaining to the offense conduct, it is determined that this inmate is: (X) COMPETENT to proceed with the disciplinary process. ( ) NOT PRESENTLY COMPETENT, but could become competent with treatment; it is recommended that the inmate for an updated competency assessment in 30 days. () NOT COMPETENT and not likely to become competent. Generated 07/30/2019 12:33 b~lbi(5J; lbl(7>cc) ~syD Bureau of Prisons - NYM Page 1 of 2

Page 2622 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/30/2019 12:01 Provider: "'" ·b'"" )<6.,.... ); <~b)=rn..,. (c.,.... > --...... syD Completed by I mer :b)<6>; {b){7)(c ) on 07/30/2019 12:33 Generated 07/30/2019 12:33 br (6); (b)(7)(C) jPsyD Bureau of Prisons - NYM Page 2 of 2

Page 2623 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/30/2019 12:01 Provider: ~M~~~--F....;;.,acility: NYM f b)(6); (b)(7)(c> F syD Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation He stated he hasn't slept well at MCC-NY because he hasn't had his cpap machine. He stated it is here and he will be able to start using it tonight. He discussed how he does not think he will able to sleep in SHU and how he does not like SHU because of the noise. He discussed issues on not getting some medication with Medical today. The "Eating/Shower Chart" indicated yesterday he ate breakfast and dinner, drank liquids, and took a shower when offered and so far today it noted he ate breakfast and drank liquids. The Psych Observation Log noted he slept, drank water, went to legal, and talked to an Inmate Companion about investments. Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. There was no indication of disturbed thought process or content. Intellectual ability appeared to be above average. Personal hygiene was adequate. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. lntervention(s) Supportive and educative interventions were provided. When asked about the Turning Point handouts for coping in SHU, he stated he already knows these strategies before he read the handouts and had tried them when he was in SHU the last time. He stated with the noise in SHU, he said the strategies will not work. He was encouraged to try them. Progress/ Plan The Chief Psychologist was consulted. Psych Observation will be discontinued. Mr. Epstein was educated about both routine and emergency procedures for contacting Psychology staff. He will be seen in follow up by Psychology tomorrow to monitor his mental status and to provide further intervention if needed and he was informed that he will be seen by Psychology tomorrow. In the meantime, he was encouraged to self-refer to Psychology if needed to which he agreed and seems capable of doing. If he remains in SHU, he will be seen by Psychology in SHU Rounds and in SHU Reviews. The SHU Lt. was informed that Mr. Epstein needs to be housed with an appropriate cellmate. Completed b~(b)r5i: (bJC1>ccJ IPsyD on 07/30/2019 13:54 Generated 07/30/2019 13:54 b f bl(6l: (b)C7J(CJ jPsyD Bureau of Prisons - NYM Page 1 of 1

Page 2624 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/29/2019 10:01 Provider: M Facility: NYM "'"f b""' >t5,,... U ,,..., b)=(7i"" tc,,... ) --.IP h D/C h ief Unit Team: 5 Focus of Session Inmate Epstein was seen while on psychological observation today in the hospital area. Subjective/Objective Presentation Same presentation today, but he said he thinks his memory for the incident (injury to his neck) may be impaired because of his sleep apnea. He is supposed to get his CPAP machine today. He is aware he will be returning to SHU, but said he is feeling unwell due to his inability to sleep and numbness in his arm. He requested to have one good night of sleep with his CPAP and will return to SHU with a cellmate tomorrow. l(b)(7)(Al I f biITiCA> I I told him he can stay down one more night to receive his CPAP and a good night's sleep, but that he would be returned to SHU tomorrow. It was explained that there is no mental health issues precluding him from returning to SHU tomorrow and that we could not house him in the SW/Hospital area because~ 1Cb)t7i(A> lor more comfortable for him ..... b_,IT_>cA_> ___________________________ __, According to his log book and eating/shower chart, he has been eating and drinking when not in his legal visits. He has also been writing and attending his legal visits. lntervention(s) Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was somewhat receptive to these interventions, but appears more concerned about getting his various needs in the prison (phone calls, recreation, housing placement concerns, etc.) Progress/Plan He will remain on psychological observation today and will transition to the SHU tomorrow. He will be seen by psychology daily to assess his mental status and psychological functioning. Completed b (blC5>; (bJ(?)(c> PhD/Chief Psychologist on 07/29/2019 10:26 Generated 07/29/2019 10:26 by b,(G); (bl(7)(C) PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2625 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/28/2019 08:33 Provider: ~r =)(6~);(~b)=~)=(C-) -~I PsyD Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" noted that yesterday he ate breakfast. He is not in the Psych Observation cell for about 12 hours per day because of being in Attorney Conference with his Attorneys, so the "Eating/Shower Chart" may not reflect all of his meals. He stated he was served one meal in Attorney Conference yesterday. He stated he drinks a lot water at night. The Psych Observation log noted he talked about life in general population and he slept. Earlier he had complained that his right arm was numb and hanging. Nurse .b)l5l;(b)(?)(c from Medical had seen him for this. When this writer was interviewing him, he said his right arm still feels somewhat numb and he said he cannot make a fist with that hand. He also said he has numbness on his neck. This writer notified Nursefb)<51;(b>c7xc> I He stated last night when he flushed the toilet it kept flushing for 45 minutes. He stated he found it so aversive and upsetting that he said he sat in the corner and held his ears. He said because of this he was agitated for hours and was not able to sleep. The Lt. will be moving him to a different cell and he was informed of this. He stated the feeling he got with the noise of the toilet was similar to when he was in SHU. He said he may have something on the Autism spectrum. He said in the movie "Rain Man," the person with Autism had an aversion to noise. He stated he is also really good with numbers. Current Mental Status: He exhibited a mildly anxious mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation and he agreed to immediately tell staff and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmate Companions if he has these thoughts. lntervention(s) Supportive and educative interventions were again provided. He had not been given the Turning Point handouts yesterday that were on his cell door, so they were handed to him by staff today. Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arrangements to be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed b~bH5i <blmcc> IPsyD on 07/28/2019 09:24 Generated 07/28/2019 09:24 byl(b)(G); (b)~l(C) jPsyD Bureau of Prisons - NYM Page 1 of 1

Page 2626 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/27/2019 07:14 Provider: =M~=--F--.-acility: NYM (b)(6); (b)(7)(C) I PsyD Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, an 'b)(7)(A) He stated that for the 5 da s 15 e had onl sle t about 30 minutes each ni ht because of noise in SHU. (b)(?)(A> (b)(l)(A) (b)(7XA) He said he has an appetite and is eatI because he is not drinking enough water bee his Attorney. Medical was e-mailed with his o is waking up every 1 1 /2 hours. He stated he feels dehydrated tated he feels he is not given enough bathroom breaks while with t f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mo ly full range of affect. His speech was logical and coherent, with no loosening of associations or tange ntial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. e ~- n engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated" ." He added he does not like pain and even does not like when he has to give blood. He agreed to immedia t aft and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He do o be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and lnmat o I ns if he has these thoughts. lntervention(s) Supportive and educative interventions were provided, He was given Turnin P douts on stress management, sleep, and building a routine in SHU. He stated he wants it noted in his chart th ~ given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him f g. Progress/Plan ~ He will remain on Psych Observation in an abundance of caution and pending housing arr ge "Jibe made on Monday. While on Psych Observation, he will be seen daily by Psychology. ' Completed bf biC5>: Cb)C?J<c) IPsyD on 07/27/2019 08:16 Generated 07/27/2019 08:16 bf blC6>:CbiC7J(cJ jPsyD Bureau of Prisons - NYM Page 1 of 1

Page 2627 Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/27/2019 07:14 , J b'(6)· (b'(7)(C) I Amendment made to this note byi._' '_ · _' __ ___. PsyD on 07/28/2019 09:19. Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM

Page 2628 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/27/2019 07:14 Provider: ..,..,M~~,,,..,..--F....,acility: NYM 'bH6>; (b)\7)(c > PsyD Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, and slept. (b)(7)(Al He stated that for the 5 days before that he had only slept about 30 minutes each night because of noise in SHU. (b)(7)(A) (b)(7)(A) He said he has an appetite and is eating. He said he is waking up every 1 1 /2 hours. He stated he feels dehydrated because he is not drinking enough water because he stated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his complaint of feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated "I'm a coward." He added he does not like pain and even does not like when he has to give blood. He agreed to immediately tell staff and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmate Companions if he has these thoughts. lntervention(s) Supportive and educative interventions were provided. Turning Points handouts on stress management, sleep, and building a routine in SHU were placed on his cell door to be given to him when his food slot is opened. He stated he wants it noted in his chart that he is being given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him from sleeping. Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arrangements to be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed bf >15>: lbJ(?J(c> r syD on 07/28/2019 09:19 Generated 07/28/2019 09:19 b lbl(5i:<bX7>CC) PsyD Bureau of Prisons - NYM Page 1 of 1

Page 2629 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/27/2019 07:14 Provider: ~ M~=-~Facility: NYM 'b)(6); (b)(7)(c> PsyD Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, an (b)(7)(A) (b}(7)(A) 'b}(7)(A) He He said he has an appetite and is eatI because he is not drinking enough water bee his Attorney. Medical was e-mailed with his o is waking up every 1 1 /2 hours. He stated he feels dehydrated tated he feels he is not given enough bathroom breaks while with t f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mo ly full range of affect. His speech was logical and coherent, with no loosening of associations or tange ntial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. e ~- n engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated" ." He added he does not like pain and even does not like when he has to give blood. He agreed to immedia t aft and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He do o be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and lnmat o I ns if he has these thoughts. lntervention(s) Supportive and educative interventions were provided. He was given Turnin P douts on stress management, sleep, and building a routine in SHU. He stated he wants it noted in his chart th ~ given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him f g. Progress/Plan ~ He will remain on Psych Observation in an abundance of caution and pending housing arr ge "Jibe made on Monday. While on Psych Observation, he will be seen daily by Psychology. ' Completed b/ b)(6>; (bJ(?>cc> ho on 07/27/2019 08:16 Generated 07/27/2019 08:16 b~(b)(6); (bl(7)(C) f syD Bureau of Prisons - NYM Page 1 of 1

Page 2630 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/26/2019 09:09 Provider: ,,,M""'""'~,,,.,...-____., acility: NYM 'b)(6>; (b)(7)(c> PhD/Chief Unit Team: 5 Focus of Session Inmate Epstein was seen while on psychological observation in our hospital area. Subjective/Objective Presentation Prior to this writer's contact with him, Inmate Epstein showered and dressed himself for his legal visit today. He was smiling and did crack some jokes during the interview. He did elucidate some complaints and suggested being disappointed with this writer as he wants "to trust me and for me to trust him." He stated he remains unhappy with legal visiting procedures as he cannot go to the bathroom as frequently as he would like to since he has a "weak bladder." Inmate Epstein also reported since coming to the psychological observation area, he has felt constipated and needs his Colace. He had self-carry Colace in SHU, but since coming to the observation area, he has not had his medication. This writer immediately notified medical and his pills were being processed during the interview. Inmate Epstein also continues to complain about the conditions of SHU confinement (i.e., feeling punished, smells, noise, and restrictions). l(blf?)IA) I He does not exhibit symptoms of any cognitive disorder, seizure disorder, psychotic disorder, or dissociative disorder at this time or in the past. Inmate Epstein denied any current suicidal ideation, intention, or plan. He reported wanting to be alive to fight his legal case and go back and live life. He referred to himself as "a coward" and "I'm Jewish." He said he is not the type who likes pain or would ever attempt to harm himself. While on psychological observation, inmate Epstein has been eating his meals, sleeping and interacting with the inmate companions. He is in legal visiting the majority of the day and in the evenings. His log book and eating/shower chart reflect the same. He has been speaking to inmate companions about investment strategies and about prison adjustment. Correctional Staff report during his legal visits, he is interacting with his attorney, animated, laughing, and joking. lntervention(s) Inmate Epstein was provided with supportive and coping skills interventions today. He was receptive to them, but mostly wanted to express his complaints about his current prison confinement status and needs. He wanted this writer to address them. Progress/Plan Inmate Epstein will remain on psychological observation in an abundance of caution and pending housing arrangements to be made on Monday. (bJIT)(A> lb)(7)(A) Completed b~bl(6); (b><7>rC> f hD/Chief Psychologist on 07/26/2019 10:05 Generated 07/26/2019 10:05 b (b)(6): (b)(7)(C) PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2631 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/25/2019 10:14 Provider: ..,...,.,,,M.,....,,..,.= .,...-------1 acility: NYM :bH5>;<b:mrc> PhD/Chief Unit Team: 5 Focus of Session Inmate Epstein was seen by this writer this morning while on psychological observation in the hospital area of the prison. Subjective/Objective Presentation Inmate Epstein was in good spirits today and engaged in reciprocal conversation with this writer this morning. He smiled and remarked, "welcome back" when this writer arrived. (blt7:tA> b)(7)(A) 'b)(7)(A) (b}(7)CA> Is wn er a emp e o ge a more ave such impairments in memory as he does not suffer from an acute cognitive disorder, he smiled and said he understood my position. Inmate Epstein did reveal he is unhappy with his current confinement in Special Housing (SHU) as he considers it "a punishment cell." He said he finds the restrictions up there unfair as he has not done anything wrong. Inmate Epstein stated he feels it is dangerous in the SHU, he cannot sleep well up there due to noise from the other inmates, it smells, and it is difficult for him to work on his legal case up there. He stated he has not received the phone calls he was promised nor has he been able to receive recreation. It was explained to him that he spends the entire day in the attorney conference room and it is likely that he has missed the times when staff members have attempted to give him phone calls and recreation. Inmate Epstein also reported complaints about the attorney conference room, stating they do not take him to the bathroom frequently enough. Inmate Epstein adamantly denied any suicidality at this time, stating "I am too vested in my case to fight it, I have a life and I want to go back to living my life." He denied any acute symptoms at this time. According to his log book, he has been eating, drinking, sleeping, and interacting with the inmate companions. He has also been attending his daily legal visits. lntervention(s) Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was mostly receptive to these interventions. He requested to be housed in general population rather than the SHU and stated he wanted to remain on psychological observation due to his concerns with being in the SHU. Progress/Plan In an abundance of caution, inmate Epstein will remain on psychological observation. (b)(?)(A) b)(7)(A) Inmate Epstein will be seen daily by psychology while on Completed b~b>C5l; <b)(?)(c> I PhD/Chief Psychologist on 07/25/2019 10:43 Generated 07/25/2019 10:43 b f b)(6); (b)(l )(C) r hD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2632 Bureau of Prisons Psychology Services Post Suicide Watch Report **SENSITIVE BUT UNCLASSIFIED** Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Date: 07/24/2019 09:23 Provider: Watch Start Date: 07/23/2019 01 :40 Total Time on Watch: 31 hrs 5 minutes Watch Conducted By: Both inmates and staff Current Mental Status Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal M Facility: NYM ~t b)(_6_): (-b)(7_ )_(C_) ---~f h.D. Watch Stop Date: Unit Team: 5 07/24/2019 08:45 Transfered to Medical Center: No Current Mental Status: Mr. EPSTEIN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited a neutral affect with appropriate range. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, circumstantial, or irrelevant content. Ttiere was no evidence of perceptual disturbance, delusional ideation, or a formal thought disorder. He did not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN explicitly denied recent and current suicidal ideation, planning, and intent. He was future-oriented and expressed a commitment to life and safety, agreeing to contact staff immediately should he experience suicidal ideation or psychological distress. He also denied thoughts of harming others. Risk Factors Assessed: This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self harm. The following STATIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connections, Sex offender status The following DYNAMIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: Current physical pain, Fear for own safety The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suicidal ideation/intention/plans, Future orientation, View of death as negative, Willingness to engage in treatment . J b)(7)(A) Risk Factors:, (b)(7)(A) Protective Factors: Mr. EPSTEIN adamantly denied current suicidal ideation or intent or a history of suicide attempts. He stated, "I have no interest in killing myself." He explained, although his situation is "not perfect" due to his being incarcerated, he noted he has "lots to do for [his] legal case." He described having a "wonderful life," to include interactions with "interesting people and projects." He said "it would be crazy" to take his life. He furthered, "I would not do that to myself." He denied feelings of hopelessness, although did report being "depressed" and "unhappy" about his current legal situation. He previously denied a history of childhood abuse. He reported he is sleeping adequately now that he is no longer in the SHU. He appear future-oriented as he endorsed an interest in being housed in general population. Weighing of Risk and Protective Factors: Mr. EPSTEIN adamantly denied sucidality. However rbt(7>(A) (b)(7KA) Generated 07/24/2019 12:09 b :bXG): (b)(7)(CJ Ph.D. Bureau of Prisons - NYM Page 1 of 3

Page 2633 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: l(bl(5>: Cb)(7)CCJ f h.D. llb)(7)CA> land the high profile nature of his alleged offense, Mr. EPSTEIN will be stepped down from Suicide Watch to Psychological Observation. Changes in Risk Factors Assessed Upon a review of the log book, it was indicated Mr. EPSTEIN has been speaking to the inmate companions about having previously taught mathematics and physics. He has been observed pacing the cell as well as sleeping, eating, and drinking within normal limits. Upon interview today, Mr. EPSTEIN requested he be provided a toothbrush as well as a shower. His requests were made known to the lieutenants and he was provided a shower prior to attending his legal visit. This writer also provided him a toothbrush, toothpaste, and hygiene products. b)(7)(A) Reason for Removal from Watch Mr. EPSTEIN stated, "I have no interest in killing myself." He explained although his situation is "not perfect" due to his being incarcerated, he noted he has "lots to do for [his] legal case." He described having a "wonderful life," to include interactions with "interesting people and projects." He said "it would be crazy" to take his life. He furthered, "I would not do that to myself." Mr. EPSTEIN did express a feeling of safety being housed on Psychological Observation rather than in the SHU. He asked if he could remain on this status for a couple of days, he was advised his housing situation will be re-evaluated on a day-to-day basis. He expressed a desire to be housed in general population rather than in the SHU and asked if there were a "safer" unit for him to be housed in comparison to the one where he was initially placed. Mr. EPSTEIN claimed there were many MS-13 gang members on the initial unit. He was advised he will be maintained on Psychological Observation in the near future, but his long-term housing situation will be revisited, as it is not ideal for one to remain in isolation on Psychological Observation for extended periods of time. Mr. EPSTEIN acknowledged this information and thanked this writer for her explanation and time. Diagnosis: No Diagnosis, No Ox - Current Conclusions The Overall Acute Suicide Risk for this Inmate is: Overall Chronic Suicide Risk for this Inmate is: Recommendations Low Absent 1. Mr. EPSTEIN will be removed from Suicide Watch and stepped down to Psychological Observation. 2. While on Psychological Observation, he will be continuously observed by Inmate Companions. 3. While on Psychological Observation, he will be seen daily by Psychology. 4. Supportive and educative interventions were provided. 5. Mr. EPSTEIN was provided novels and a request was made for his legal paperwork to be provided to him on Psychological Generated 07/24/2019 12:09 b f bl(6); (b)(?)(C) I Ph.D. Bureau of Prisons - NYM Page 2 of 3

Page 2634 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Date: 07/24/2019 09:23 Provider: Observation. M Facility: NYM ~,(b-)(6-);(-b)-(7-)(C-) ---~, Ph.D. Unit Team: 5 6. This writer contacted the Pharmacy to indicate Mr. EPSTEIN has not been receiving his medication used to alleviate his constipation. 7. Mr. EPSTEIN attended a legal visit today, after having been provided a shower. 8. Mr. EPSTEIN was educated about both routine and emergency procedures for contacting psychology. 9. The inmate was encouraged to reach out for PRN services should he experience any psychological distress. Completed b ~ lb/ts,; tb/mtc > !Ph.D. on 07/24/2019 12:09 Generated 07/24/2019 12:09 br )(S); (b)(?)(C) I Ph.D. Bureau of Prisons - NYM Page 3 of 3

Page 2639 Inmate Name: Date of Birth: Date: Placed in SHU: Status: Basis of Review: Mental Status: Comments Bureau of Prisons Psychology Services SHU Review EPSTEIN, JEFFREY EDWARD Sex: 01/20/1953 07/18/2019 07:21 .---M~~----.-Facility NYM Provider: bJ(G); (blcncc> hD/Chief 07/10/2019 ADM IN.DETENTION Inmate was interviewed No significant mental health issues. Type: Threat to Self: Adjustment: Threat to Others: Monthly SHU Review Note **SENSITIVE BUT UNCLASSIFIED** SHU Reg #: 76318-054 Unit Team: A&O Low Satisfactory, segregation not detrimental Low Inmate Epstein was meeting with his legal team today and has a court hearing. He was not able to be seen for a SHU review. Another attempt to interview him for a SHU review will be done in the near future. Completed b{ b)(GJ;<b)cncq !PhD/Chief Psychologist on 07/18/2019 12:06 Generated 07/1 8/2019 12:06 b f b)(G); (b)(7)(C) f hD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2640 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/16/2019 12:48 Provider: ,,,..,.,.,M-:'--:,-,-=,--___,, acility: NYM (b)(6); (b)<7><c> PhD/Chief Unit Team: A&O Focus of Session Inmate Epstein called for this writer in attorney conference today. The officer in attorney conference notified this writer that he was asking to be seen. Subjective/Objective Presentation Inmate Epstein reported he has not received a spoon or soap in SHU, nor did he receive the phone calls that were "promised to him." He told this writer we need to have mutual trust that his needs are met in the prison. This writer told inmate Epstein that she would address his concerns. On the way out, a staff member told this writer she witnessed inmate Epstein receive two phone calls from the Lt. Nonetheless, this writer informed the SHU lieutenant of his concerns and he said he would ensure that he had soap, a spoon, and his initial SHU phone call. Inmate Epstein did not have any psychological concerns today. He denied any mental health symptoms or suicidality. He has been eating as best as he can and has requested a Kosher diet. lnterventionls) Inmate EPSTEIN was provided with brief supportive and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was receptive to these interventions. He continued with his legal visit. Progress/Plan Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He was reminded of the self-help books and audiotapes available through the Psychology department. There appears to be no need for follow up at this time. He will be seen in SHU for rounds and monthly SHU reviews. Completed b~ b)(6); (bl<7><c> !PhD/Chief Psychologist on 07/18/2019 13:05 Generated 07/18/2019 13:05 b bl(6): (bi(7i(Ci PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2641 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/11/2019 15:21 Provider: ..,...M,.,,,.,..,~=,----,Facility: NYM rb){6): (b)(7;(C) t hD/Chief Unit Team: A&O Focus of Session Inmate Epstein was seen for his psychological observation follow-up in attorney conference this afternoon. Subjective/Objective Presentation Inmate Epstein reported he has been consulting with his attorney most of the day. He elucidated concerns about his incarceration including not receiving his property yet in SHU, feeling cold in his cell, not receiving his Colace, not having enough water in attorney conference, and a desire to recreate in SHU." Inmate Epstein was also upset about wearing an orange jumpsuit and being treated like "a bad guy" when he did not do anything wrong in the prison. Custody and security concerns were addressed with inmate Epstein including why he has to wear his orange jumpsuit (due to his being housed in SHU). He requested that he be placed in a brown uniform during his legal visits. He was told his concerns would be addressed in the SHU meeting. (b)(7)(A) 'bK7l<A> He did not sleep well last night. Inmate Epstein continues to deny any suicidal ideation, intention or plan. He did not appear to be in any distress at this time. lntervention(s) Inmate EPSTEIN was provided with brief supportive interventions, CBT-based interventions, and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was receptive to these interventions. Progress/Plan Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He was reminded of the self-help books and audiotapes available through the Psychology department. He will be seen next week after his bail hearing to assess his mental status and psychological stability. Completed b~(bll5l: <o)(?)(c) !PhD/Chief Psychologist on 07/12/2019 07:51 Generated 07/12/2019 07:51 bt bHGJ: fb~7)(CJ FhD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2642 Inmate Name: Date of Birth: Date: Comments Bureau of Prisons Psychology Services General Administrative Note EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: 07/11/2019 14:28 Provider: M Facility: NYM ,.,,...lrb)=c6J,....,cb,..,.,1a"">1c=i----,IPsyD **SENSITIVE BUT UNCLASSIFIED** Reg#: 76318-054 Unit Team: A&O This writer attempted to see Mr. Epstein in the morning and then again in the afternoon for a Psych Observation Follow Up, but he was in Attorney Conference. Completed b~(b)(SJ: (b)C?KC> IPsyD on 07/11/2019 15:51 Generated 07/11/2019 15:51 b{ b)(G); Cb)(7)CC> IPsyD Bureau of Prisons - NYM Page 1 of 1

Page 2643 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/10/2019 08:38 Provider: M Facility: NYM .,..tb)""' c5.,..., ): (,,..,. b)(=7)=(c,- ) --,!PhD/Chief Unit Team: A&O Focus of Session Inmate Epstein was seen today for a psychological observation contact in the hospital area by this writer. Subjective/Objective Presentation Inmate Epstein appeared well and it was noted in his log book and eating/sleeping chart that he has been eating his meals, sleeping, interacting with the inmate companions, and pacing in his cell. Today, he presented this writer with numerous concerns and requests. He stated he does not want to be housed in the SHU because he is not comfortable there; he wants to be single-celled if he goes to the SHU; he wants Colace, not the Ducolex he received from medical yesterday; he wants to be able to walk around and go to recreation; he does not want to wear an orange uniform to his legal visits because he is treated "like a punished inmate;" he wants a phone call before he leaves the psychological observation area; he wants a shower and towel; he would like to be housed in the cadre (5S) unit; and would like his property, paper, and a pen. Inmate Epstein's concerns were addressed by this writer and it was explained to him he will not be single-celled or placed in a housing unit for safety and security concerns. His medical concerns (constipation) were discussed with health services as well as his desire to be placed on Colace. Inmate Epstein was provided a shower this morning. lntervention(s) Inmate Epstein was provided with supportive intervention and coping skills strategies today. He was receptive to interventions and was able to elucidate his various needs. He did not present with any acute psychopathology and continues to deny any suicidal ideation, intention, or plan. He is looking forward to his bail hearing on Monday but stated he is aware that even if he gets bail, it will take at least two weeks to sort things out so he can leave the jail. Progress/Plan Inmate Epstein is not in any psychological distress, does not present with any mental health symptoms or complaints, and is denying any suicidality. He appears psychologically stable at this time and can be released from the psychological observation area. Inmate Epstein will be housed in the 9S area with a cellmate. He will be seen again tomorrow by psychology to evaluate his mental status and psychological stability. Completed b :bl<6>: CblC7lcc> PhD/Chief Psychologist on 07/10/2019 09:09 Generated 07/10/2019 09:09 b1:biC6>: (b)(7)(C) !PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2644 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: M Facility: NYM 07/09/2019 10:13 Provider: ~jtb=x5->;-(b)~(7=)(c~>-~phD/Chief Unit Team: A&O Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time. Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in th ast. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink I. P ol Inmate Epstein was seen ·sk assessment today for precautionary reasons. He did not mark any mental health items or symptoms on h ology Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors • y including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had proceeding yesterday which could have given him bad news regarding his legal situation. Inmate Epstein return ~~-7, er duty hours yesterday evening and staff notitied the on·call psychologist. Inmate Epstein was placed on Ionary psychological observation status until psychology could interview him this morning to conduct a for • risk assessment to determine whether he is currently at-risk for suicidality. ~ Diagnostic Formulation Inmate Epstein has no history of mental health proble ~ not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment I any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologic ~ nd is in no psychological distress. As such, he is being classified as a CC1 -MH inmate at this time. CARE1 -M s • c e of an inmate who either has no identifiable mental illness (Axis I "No Diagnosis") or is mildly ill and requires c ni ention on an as-needed basis. Care Level Formulation illness and demonstrates no need for regular mental health intervention. Diagnosis: Completed bytbl(6J <bll7>(C> f hD/Chief Psychologist on 07/09/2019 10:32 Generated 07/09/2019 10:32 b (b)i5): (b)(7)(C) PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2645 Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/09/2019 10:13 Reg#: Race: Facility: Amendment made to this note byl(bH5>;<bi(7)rc> f hD/Chief Psychologist on 07/09/201910:40. Bureau of Prisons - NYM 76318-054 WHITE NYM

Page 2646 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: M Facility: NYM 07/09/2019 10:13 Provider: ~rb=)(S-);(~b)(7=)(=c)-~IPhD/Chief Unit Team: A&O Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time. Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Presenting Problem/Symptom Inmate Epstein was seen by this writer for suicide risk assessment today, 7/9/19 at 7:30 a.m. for precautionary reasons. He returned from court yesterday evening. He did not mark any mental health items or symptoms on his Psychology Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors for suicidality including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal situation. Inmate Epstein returned from court after duty hours yesterday evening and staff notified the on-call psychologist. Inmate Epstein was placed on a precautionary psychological observation status until psychology could interview him this morning to conduct a formal suicide risk assessment in order to determine whether he is currently at-risk for suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health problems and does not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment and denied any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologically stable and is in no psychological distress. As such, he is being classified as a CC1 -MH inmate at this time. CARE1 -MH is indicative of an inmate who either has no identifiable mental illness (Axis I "No Diagnosis") or is mildly ill and requires clinical intervention on an as-needed basis. Care Level Formulation CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Ox - Current Completed b~(b)(sr (b)(?Xc> f hD/Chief Psychologist on 07/09/2019 10:40 Generated 07/09/2019 10:40 b~(bll6l; <bH7l<ct f hD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2647 Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 10:13 Provider: "'"l 1b=)<6,.... >: <""" b)=(7x=c ,.... > --.IP h D/C h ief Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time. Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in th ast. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink I. P ol Inmate Epstein was seen ·sk assessment today for precautionary reasons. He did not mark any mental health items or symptoms on h ology Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors • y including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had proceeding yesterday which could have given him bad news regarding his legal situation. Inmate Epstein return ~~-7, er duty hours yesterday evening and staff notitied the on·call psychologist. Inmate Epstein was placed on Ionary psychological observation status until psychology could interview him this morning to conduct a for • risk assessment to determine whether he is currently at-risk for suicidality. ~ Diagnostic Formulation Inmate Epstein has no history of mental health proble ~ not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment I any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologic ~ nd is in no psychological distress. As such, he is being classified as a CC1 -MH inmate at this time. CARE1 -M s • c e of an inmate who either has no identifiable mental illness (Axis I "No Diagnosis") or is mildly ill and requires c ni ention on an as-needed basis. Care Level Formulation illness and demonstrates no need for regular mental health intervention. Diagnosis: Completed by tbH6), <blrncc> PhD/Chief Psychologist on 07/09/2019 10:32 Generated 07/09/201910:32 b~bl(6):(bi(7iCCi !PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2648 Bureau of Prisons Psychology Services Suicide Risk Assessment **SENSITIVE BUT UNCLASSIFIED** Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: f b>(6i:cn)c7)(c> !PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record Inmate Epstein was placed~ n chological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He i a suicide watch at this time. Reason for Referral Inmate Epstein is being seen ~ e risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at th~ming a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court o ing yesterday which could have given him bad news regarding his legal situation. As such, this writer instruc &D staff swell as the Lieutenant's Office, to immediately notify the psychology department when he returned fro Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notifi -call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psycholo • terview him this morning to conduct a suicide risk assessment. Developmental History Educational History/Cognitive Impairment Inmate Epstein denied any history of being the victim n ~ trator of physical or sexual abuse. Inmate Epstein reported he obtained his high school diplom ~ ed some graduate classes in the area of mathematics. Arrest History and Experience of Incarceration ~ Inmate Epstein reported he has served time in Palm Beach County jaily~~~ e charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History Inmate Epstein denied any history of mental health treatment, either on an inpati ~ tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d,~~ute mental health symptoms at this time. Self-Harm History , 6 Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever eflging in any suicide attempts or self-injurious behavior in the past. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Level of Consciousness: Alert and Oriented Generated 07/09/2019 10:36 by 'oJ(B): (bJ(7;(Cl PhD/Chief Bureau of Prisons • NYM Page 1 of 3

Page 2649 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01 /20/1953 Sex: M~ ___.. .................. ...., NYM UnitTeam: A&O 07/09/201908:41 Provider: .b)C5>: <b)(7)(C> PhD/Chief Psychologist Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. Current Mental Status: Mr. EP a neutral affect with approP,ri and volume. His thoughts er irrelevant content. There IN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited e. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, r nized and coherent, with no loosening of associations or tangential, circumstantial, or not engage in any bizar explicitly denied recent commitment to life and ce of perceptual disturbance, delusional ideation, or a formal thought disorder. He did e behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN • eation, planning, and intent. He was future-oriented and expressed a tact staff immediately should he experience suicidal ideation. D: This writer screened the inmate for a variety of validated factors commonly associated with risk for self-harm and suicide. The following STATIC risk factors were assessed t d increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connecti ender status Of the DYNAMIC risk factors assessed, none were fo nt. The following PROTECTIVE factors were assessed to be pres ~ y decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suici • • tention/plans, Future orientation, View of death as negative, Willingness to engage in treatment As noted above, Inmate Epstein is a 66-year-old Caucasian male. He k factors for suicidality at this time including a high profile case with extensive media attention, sex offense/tr ·c • s, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his leg ate Epstein also informed this writer that his only family at this time is his brother, with whom he does not hav tionship with. Despite these risk factors, inmate Epstein possesses a number of protective factors a m Inmate Epstein adamantly attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writ r • d said "I have my paper denied any suicidal ideation, intention or plan. He was very future oriented and requeste ~ all, to meet with his spoon here." He reported he is going to have a bail hearing on Monday and believes he is go gt ~ sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "bei I' fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as mpetent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS: No Diagnosis, No Ox - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Overall Chronic Suicide Risk for this Inmate is: Generated 07/09/2019 10:36 b r b)(6): (b){?)(C) I PhD/Chief Low Absent Bureau of Prisons • NYM Page 2 of 3

Page 2650 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M F acil it NYM Unit Team: A&O Date: 07/09/201908:41 Provider: (blC5>: lb)(7)(C> hD/Chief Psychologist RECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed byfb>(5>: (b;(7J(c> I PhD/Chief Psychologist on 07/09/2019 10:36 ~ ~$ ~~ ~$ ~;t Generated 07/09/2019 10:36 b ~(b)(S); (b){?)(C) f hD/Chief Bureau of Prisons • NYM Page 3 of 3

Page 2651 Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/09/201908:41 Reg#: Race: Facility: Amendment made to this note b~ b)<5>:<b><ncc) f hD/Chief Psychologist on 07/10/2019 09:20. Bureau of Prisons - NYM 76318-054 WHITE NYM

Page 2652 Bureau of Prisons Psychology Services Suicide Risk Assessment **SENSITIVE BUT UNCLASSIFIED** Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: .bJCGJ; (bJC7)(c ) PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Medical Record, Clinical Interview Inmate Epstein was placed on psychological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He is not on a suicide watch at this time. He was seen this morning for a psychological observation contact and suicide risk assessment this morning, 7/9/19, at 7:30 a.m. as it was determined he possessed some at-risk factors for suicidality. Reason for Referral Inmate Epstein is being seen for suicide risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at this time including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal situation. As such, this writer instructed R&D staff, as well as the Lieutenant's Office, to immediately notify the psychology department when he returned from court. Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notified the on-call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psychology could interview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim and/or perpetrator of physical or sexual abuse. Educational History/Cognitive Impairment Inmate Epstein reported he obtained his high school diploma and attended some graduate classes in the area of mathematics. Arrest History and Experience of Incarceration Inmate Epstein reported he has served time in Palm Beach County jail on sex offense charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time. Self-Harm History Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Generated 07/10/2019 09:20 b 1 b)(G); {b)[7)(Cl f hD/Chief Bureau of Prisons • NYM Page 1 of 3

Page 2653 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01 /20/1 953 Sex: M F acil it Date: 07/09/2019 08:41 Provider: b)(6U b)<7:<c> Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Reg #: 76318-054 NYM Unit Team: A&O PhD/Chief Psychologist Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. Current Mental Status: Mr. EPSTEIN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited a neutral affect with appropriate range. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, circumstantial, or irrelevant content. There was no evidence of perceptual disturbance, delusional ideation, or a formal thought disorder. He did not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN explicitly denied recent and current suicidal ideation, planning, and intent. He was future-oriented and expressed a commitment to life and safety, agreeing to contact staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS ASSESSED: This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self-harm and suicide. The following STATIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: Sex offender status, Lack of family connections, High Profile Crime Of the DYNAMIC risk factors assessed, none were found to be present. The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Willingness to engage in treatment, View of death as negative, Future orientation, Denial of suicidal ideation/intention/plans, Adequate problem solving skills, Able to identify reasons to live As noted above, Inmate Epstein is a 66-year-old Caucasian male. He has various risk factors for suicidality at this time including a high profile case with extensive media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his legal situation. Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not have a close relationship with. Despite these risk factors, inmate Epstein possesses a number of protective factors at this time. Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requested a phone call, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writer arrived and said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is going to be released from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "being alive is fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as "competent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS: No Diagnosis, No Ox - Current Generated 07/10/2019 09:20 b 1 b)(6); (b}(7)(C) I PhD/Chief Bureau of Prisons • NYM Page 2 of 3

Page 2654 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1 953 Sex: M F acil it Date: 07/09/2019 08:41 Provider: (b)(5>; <b)(?)(C) CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Overall Chronic Suicide Risk for this Inmate is: RECOMMENDATIONS Low Absent Reg #: 76318-054 NYM Unit Team: A&O PhD/Chief Psychologist Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1 -MH inmate at this time. CARE1 -MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed bytbl(5); Cb)C?)(c> I PhD/Chief Psychologist on 07/1 0/2019 09:20 Generated 07/10/2019 09:20 b (b)i6); (blC7lCCi PhD/Chief Bureau of Prisons • NYM Page 3 of 3

Page 2655 Bureau of Prisons Psychology Services Suicide Risk Assessment **SENSITIVE BUT UNCLASSIFIED** Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: b)CG>; (bJcncc > PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record Inmate Epstein was placed~ n chological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He i a suicide watch at this time. Reason for Referral Inmate Epstein is being seen ~ e risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at th~ming a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court o ing yesterday which could have given him bad news regarding his legal situation. As such, this writer instruc &D staff swell as the Lieutenant's Office, to immediately notify the psychology department when he returned fro Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notifi -call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psycholo • terview him this morning to conduct a suicide risk assessment. Developmental History Educational History/Cognitive Impairment Inmate Epstein denied any history of being the victim n ~ trator of physical or sexual abuse. Inmate Epstein reported he obtained his high school diplom ~ ed some graduate classes in the area of mathematics. Arrest History and Experience of Incarceration ~ Inmate Epstein reported he has served time in Palm Beach County jaily~~~ e charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History Inmate Epstein denied any history of mental health treatment, either on an inpati ~ tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d,~~ute mental health symptoms at this time. Self-Harm History , 6 Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever eflging in any suicide attempts or self-injurious behavior in the past. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Level of Consciousness: Alert and Oriented Generated 07/09/2019 10:36 b (b)CG); (b;(?i(C) PhD/Chief Bureau of Prisons • NYM Page 1 of 3

Page 2656 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01 /20/1953 Sex: M ~ ___._,.,..,.. ....... ..., NYM Unit Team: A&O 07/09/2019 08:41 Provider: (b)(Bi: (b)(?)(C) PhD/Chief Psychologist Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. Current Mental Status: Mr. EP a neutral affect with approP,ri and volume. His thoughts er irrelevant content. There IN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited e. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, r nized and coherent, with no loosening of associations or tangential, circumstantial, or not engage in any bizar explicitly denied recent commitment to life and ce of perceptual disturbance, delusional ideation, or a formal thought disorder. He did e behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN • eation, planning, and intent. He was future-oriented and expressed a tact staff immediately should he experience suicidal ideation. D: This writer screened the inmate for a variety of validated factors commonly associated with risk for self-harm and suicide. The following STATIC risk factors were assessed t d increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connecti ender status Of the DYNAMIC risk factors assessed, none were fo nt. The following PROTECTIVE factors were assessed to be pres ~ y decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suici • • tention/plans, Future orientation, View of death as negative, Willingness to engage in treatment As noted above, Inmate Epstein is a 66-year-old Caucasian male. He k factors for suicidality at this time including a high profile case with extensive media attention, sex offense/tr ·c • s, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his leg ate Epstein also informed this writer that his only family at this time is his brother, with whom he does not hav tionship with. Despite these risk factors, inmate Epstein possesses a number of protective factors a m Inmate Epstein adamantly attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writ r • d said "I have my paper denied any suicidal ideation, intention or plan. He was very future oriented and requeste ~ all, to meet with his spoon here." He reported he is going to have a bail hearing on Monday and believes he is go gt ~ sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "bei I' fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as mpetent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS: No Diagnosis, No Ox - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Overall Chronic Suicide Risk for this Inmate is: Generated 07/09/2019 10:36 b b)(G>: (b)(?)(C) PhD/Chief Low Absent Bureau of Prisons • NYM Page 2 of 3

Page 2657 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: Date: 01/20/1953 Sex: M Facility: 07/09/201908:41 Provider:l(b)C6>; Cb)C7)(c ) NYM Unit Team: A&O f hD/Chief Psychologist RECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed b~b)(S); (b)(7i(C> !PhD/Chief Psychologist on 07/09/2019 10:36 ~ ~$ ~~ ~$ ~;t Generated 07/09/2019 10:36 by bi(5i; (b)(7)(C) PhD/Chief Bureau of Prisons • NYM Page 3 of 3

Page 2658 Inmate Name: Date of Birth: Date: Comments Bureau of Prisons Psychology Services General Administrative Note EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: 07/08/2019 10:41 Provider: ,,,..M ,.,.,,.,....,,..,.,,,,.,.,,.,....----,Facility: NYM l(b)(5): (b}(?)(c) !PhD/Chief **SENSITIVE BUT UNCLASSIFIED** Reg#: 76318-054 Unit Team: A&O This writer consulted witrl(b/C5>: (b)(?)(Cl I Central Office, regarding inmate Epstein. Inmate Epstein has various risk factors for suicidality including a high profile case with media attention, sex offense charges, pre-trial status, and a court proceeding today which could potentially be giving him bad news regarding his legal situation. As such, when inmate Epstein returns from court, R&D staff as well as Lieutenant's have been informed to immediately notify the psychology department. If he returns after duty hours, the aforementioned staff were instructed to notify the on-call psychologist and to place inmate Epstein on a watch status until psychology can conduct a thorough suicide risk assessment. Completed b~b)(GJ; (b)a)cc> I PhD/Chief Psychologist on 07/08/2019 10:49 Generated 07/08/2019 10:49 by Cbl(5); (b)(?J(Cl PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Page 2659 Inmate Name: Date of Birth: Date: Comments Bureau of Prisons Psychology Services Risk of Sexual Abusiveness EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: 07/08/2019 09:35 Provider: M Facility: NYM ~(bJ=c6~>c~bJ=c1>=cc~>-----,IPsyD/PhD Risk of Sexual Abusiveness **SENSITIVE BUT UNCLASSIFIED** Reg#: 76318-054 Unit Team: A&O During the intake screening process, for Inmate Epstein, based on the documentation available at the time of the screening, and Inmate Epstein's self-report, he was identified as being at risk for sexual abusiveness due to previous perpetration of sexual abuse in the community or in an institutional setting, as evidenced by the following objective criteria: ( ) Having a history of prior institutional violence or sexual abuse perpetration (X ) Having a history of prior sexual abuse perpetration in the community (X ) Having prior convictions of violent offenses As required by P5324.11, Sexually Abusive Behavior Prevention and Intervention, Inmate Epstein was seen by Psychology on today's date to assess his risk factors for sexual abusiveness. At the onset of this clinical contact, the inmate was informed about the BOP requirements regarding PREA. Inmate Epstein indicated he understands the institution's policy against engaging in sexual behavior. His risk factors for sexual abusiveness were assessed and include: ( ) History of prior sexual victimization in prison ( X ) History of prior prison sexual predation ( ) History of head injury with loss of consciousness ( ) History of childhood psychological, physical, sexual abuse ( ) Witnessed family violence ( ) Antisocial Personality Disorder traits of irritability/aggressiveness and recklessness ( ) Hypersexuality (defined by eight or more orgasms a week prior to prison) ( ) Hypermasculinity ( ) Other: Based on this clinical assessment, the inmate is considered to be at: (X ) Low Risk of Abusiveness at this facility (Note: Even though this inmate is judged to be at low risk of sexual abusiveness, an unforeseen change in risk factors may significantly alter his risk level.). Programming recommendations included sex offender treatment. Inmate Epstein declined programming recommendations.The inmate understands the procedure for contacting Psychology for routine or emergent services. ( ) Moderate Risk of Abusiveness. The Unit Team and Correctional Staff have been notified regarding Psychology staff's recommendation that he not be housed in a cell with any inmates identified as at increased risk for sexual victimization. Psychology also recommends a greater level of supervision regarding his work and education assignments. Programming recommendations include XXXXX. Inmate =inmatelastName is agreeable to/ declined programming recommendations. ( ) High Risk of Abusiveness. It is recommended this inmate be housed in the Special Housing Unit in accordance with P5324.1 1 to "keep separate those inmates at high risk of being sexually victimized from those at high risk of being sexually abusive" until Correctional Services and Correctional Programs staff can assess his appropriateness for general population at this facility. This inmate should not be housed with any inmates judged to be at an increased risk for sexual victimization. Programming recommendations include XXXXX. Inmate =inmatelastName is agreeable to/ declined programming recommendations. Generated 07/08/2019 09:41 by[b;(5); (bl(7)(C) jPsyD/PhD Bureau of Prisons - NYM Page 1 of 2

Page 2660 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: M Facility: NYM 07/08/2019 09:35 Provider: ~,(b~)(5~) (~b:=(7l=<c~) -----.f syD/PhD Unit Team: A&O Completed b yfb)tG); (b:(7)(c> IPsyD/PhD on 07/08/2019 09:41 Generated 07/08/2019 09:41 by (bl(G); lbl(?)ICJ PsyD/PhD Bureau of Prisons - NYM Page 2 of 2

Page 2661 Inmate Name: Date of Birth: Date: EPSTEIN, JEFFREY EDWARD Bureau of Prisons Psychology Services Intake Screening 01/20/1953 Sex: M Facility: NYM 07/08/2019 09:24 Provider: j(bl(6Hb)(7Jcc> jPsyD/PhD Limits of Confidentiality **SENSITIVE BUT UNCLASSIFIED** Reg #: 76318-054 Unit Team: A&O Limits of confidentiality were reviewed with inmate EPSTEIN. He expressed an understanding of the limits of confidentiality and consented to be interviewed accordingly. Data Source(s) The following data sources were reviewed in conjunction with this Initial Intake Evaluation: Self-Report, SENTRY, Staff Observation. Inmate Epstein is a 66-year-old, Black male who was seen by Psychology Services due to newly arriving at MCC-NY. He denied a history of mental health treatment on his Psychology Services Intake Questionnaire. Mental Health History and Current Symptoms No history of mental health issues was noted. No history of prior mental health treatment was noted. No current mental health symptoms were noted. No suicidal ideation, attempts, or self-harm were noted. Substance Abuse No history of substance abuse was noted. No history of substance abuse treatment was noted. Sex Offenses No sexual offense convictions were noted. No history of sexual predation in a correctional setting was noted. Relevant Psychosocial History Noteworthy psychosocial issues: Other. Inmate Epstein is currently incarcerated for a Sex Trafficking. He stated he was previously incarcerated three months f or prostitution. Inmate Epstein stated he is single and does not have any children. He revealed he was living in New York. He stated he completed high school. He stated he was employed in banking work prior to his incarceration. Adjustment to Incarceration Adjustment to incarceration concerns were identified: Other. SEXUAL ABUSE HISTORY Inmate Epstein denied being the victim of physical or sexual abuse. He is currently charged with sex trafficking and has previously been charged with prostitution. He was informed of the programs offered by MCC-NY as well as the Bureau of Prisons. Additionally, he was informed of this institutions self-help program. Inmate Epstein reported he was not currently interested in any treatment programs. MENTAL STATUS: Inmate Epstein appeared calm, controlled, without signs of psychomotor agitation or retardation. He was fully cooperative, maintained good eye-contact, and related in an interpersonally appropriate manner with interviewer. Speech and thought processes were organized, coherent, logical, and goal-directed. Based on informal assessment during this interview, this inmate's cognitive functioning appeared within normal limits, as reflected by adequate long and short-term memory, good attention, and appropriate concentration during interview, as well as adequate receptive and expressive language skills. Inmate denied any current sleep disturbances and described his appetite as adequate. This inmate denied recent or present morbid thoughts, passive or active suicidal ideation, intent or plan and contracted for safety. This inmate's verbalizations were optimistic, future oriented, and without indications of helpless or hopeless thinking. lnmat [~;~(le> denied any familial history of suicide behaviors or attempts. This inmate was provided with supportive psychotherapy, and psycho-education to strengthen coping skills and facilitate adjustment to incarceration. Findings Care Level: CARE1 -MH Generated 07/08/2019 09:30 by~l <b-)(5-:: (-bl-(7)-(C-> -~IPsyD/PhD Bureau of Prisons - NYM Page 1 of 2

Page 2662 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/08/2019 09:24 Provider: l(b)(6l;(bJ(7)<c> f syD/PhD Reg#: 76318-054 Unit Team: A&O Inmate EPSTEIN denied any history of mental health symptoms or treatment. He denied any current mental health symptoms. He does not meet criteria for any current psychological diagnosis. He meets criteria for Mental Health Care Code 1. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Recommendations The following psychological services are recommended: Other. Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He does not appear to be in distress at this time. He agreed to contact psychology if he feels he needs psychology services in the future. He meets criteria for CC1 and does not require scheduled follow up at this time. Completed b~Ib><5>:(bit7ltC> IPsyD/PhD on 07/08/2019 09:30 Generated 07/08/2019 09:30 b~(b)(6): (b)(7J(Cl !PsyD/PhD Bureau of Prisons - NYM Page 2 of 2

Page 2663 @ Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Name EPSTEIN, JEFFREY Reg# 76318-054 DOB 01/20/1953 Sex M Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IDMS) Springfield, MO 65807 417-874-1621 Facility MCC New York Order Unit E06-547U Providerl(b)C5>; lbit7Jtc> I MD CHEMISTRY 137 4.7 99 27 17 1.05 >60 GFR units measured as ml/min/1 .73 m~2. If African American multiply by 1.210. A calculated GFR <60 suggests chronic kidney disease if found over a 3 month period. Calcium 9.8 Glucose AST ALT Alkaline Phosphatase Bilirubin, Total Total Protein Albumin Globulin Alb/Glob Ratio Anion Gap BUN/Great Ratio Cholesterol Triglycerides H H H 102 57 62 64 1 .1 7.3 4.4 2.9 1.50 10.2 16.1 216 413 *** Sensitive But Unclassified *** Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07 /10/2019 14 :46 LIS ID 188191004 137-148 3.5-5.0 99-114 22-30 7-22 0.66-1.25 8.5-10.9 70-110 11-55 11-66 41 -133 0.2-1.3 6.0-8.2 3.6-5.1 2.0-3.7 1.00-2.30 9.0-19.0 5.0-30.0 <200 10-150 mmol/L mmol/L mmol/L mmol/L mg/dl mg/dl mg/dl mg/dl U/L U/L U/L mg/dl g/dl g/dl g/dl mg/dl mg/dl Calculation of LDL is not appropriate for samples with a triglyceride greater than 400 mg/dl. Therefore the LDL is not calculated. HDL Cholesterol L 31 40-60 mg/dl Chol/HDL Ratio WBC NRBC¾ RSC Hemoglobin Hematocrit MCV MCH MCHC RDW-CV Platelet FLAG LEGEND H L 6.9 HEMATOLOGY 7.6 0.0 5.42 15.6 47.8 88.2 28.8 32.6 12.8 338 0.0-4.0 4.3-11.1 4.46-5.78 13.6-17.6 40.2-51.4 82.5-96.5 27.1-34.9 33.0-37.0 12.0-14.0 130-374 K/ul % M/ul g/dl % fl pg g/dl % K/ul L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 1 of 3

Page 2664 @ Federal Bureau of Prisons Name EPSTEIN, JEFFREY Reg# 76318-054 DOB 01/20/1953 Sex M MPV Neutrophils % U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 Facility MCC New York Order Unit E06-547U Provider l(bHs:; (b)(7 )(C > I MD HEMATOLOGY 10.4 58.7 *** Sensitive But Unclassified *** Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07 /10/2019 14 :46 LIS ID 188191004 6.9-10.5 fl % Therapeutic decision making should be based on absolute values, rather than percentages Lymphocytes% 25.0 Monocytes % Eosinophils % Basophils % Immature Granulocytes % Neutrophils # Lymphocytes# Monocytes # Eosinophils # Basophils # Immature Granulocytes # Hemoglobin A 1 C 5.7 - 6.4 Increased Risk > 6.4 Diabetes RPR H 11 .1 4.1 0.8 0.3 4.4 1.9 0.8 0.3 0.1 0.02 HEMOGLOBIN A1C 6.3 SEROLOGY Non-Reactive Results may be affected in patients with severely advanced immunosuppression. 0.0-5.0 1.9-6.7 1.3-3.7 0.3-1.1 0.0-0.5 0.0-0.1 0.00-0.50 <5.7 Non-Reactive % % % % % K/ul K/ul K/ul K/ul K/ul 1QA3/ul % FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 2 of 3

Page 2665 @ Federal Bureau of Prisons Name EPSTEIN, JEFFREY Reg# 76318-054 DOB 01/20/1953 Sex M HIV 1/2 U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 Facility MCC New York Order Unit E06-547U Providerrb)(C); (b)(?)(C) I MD HIV Negative *** Sensitive But Unclassified *** Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07 /10/2019 14 :46 LIS ID 188191004 Negative Screening test - See confirmatory testing for Reactive results FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 3 of 3

Page 2666 Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01 /20/1953 Sex: M Encounter Date: 07/10/2019 16:58 Provider: Lab Result Receive Cosigned b yj._ (b)-(5)-; (b_la_)cc_) ___ _.IMD on 07/14/2019 18:12. Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM

Page 2667 BP-S358.060 SEP05 MEDICAL TREATMENT REFUSAL CDFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-24-201 9 Date I, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: EYE DOCTOR EVALUATION. The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. I understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and { release the Bureau of Prisons and Its employees from any and all liability for respecting and following my expressed wishes and directions . . b)(6); (b)(7)(C) r )(6); (b)(7)(C) 7-24-2019 Counseled by Date Date (b)(6); (b)(? )(C) NYM--NEW YORK MCC ~/r~ '----------------