Bureau of Prisons -SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01)201953 Sex: M Facility: NYM Date: 07129/2019 10:01 Provider: PhD/Chief Reg #: 76318-054 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. He then asked if he could remain down here where it is "safe" for the entire week. 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 he felt safe or more comfortable for him. It was explained to him that he would be placed in a safe situation in the SHU. 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. Intervention(s) Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was somewhat receptive to thvg isitmeoritipas, but appears more concerned about getting his various needs in the prison (phone calls. recreation. housir% placeme-a concerns. etc.) Progress/Plan Withheld pursuant to exemption He will remain on psychological observation today a9g l.tiNiligc.t.R.,1 4U tomorrow. He will be seen by psychology daily to assess his mental status and pskliblb§afttnefia. of the Freedom of Information and Privacy Act Completed by PhD/Chief Psychologist on 07/29/2019 10:26 Generated 07)29,2019 10:26 by Phathiel Bureau of Prisons NYM Page 1 of 1 EFTA00073931

Bureau of Prisons -SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01)201953 Sex: M Facility: NYM Date: 07/28/2019 08:33 Provider: PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective PresentaisIn 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 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 Nurse 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 SHtitgelikEtaid thigrmay 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. Withheld pursuant to exemption Current Mental Status: He exhibited a mildly anxious(Pai MPS! affect. His speech was logical and coherent, with no loosening of associa4irinehtgaiAttAli fikiffifinaw rica 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. Interventions) 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 by PsyD on 07/28/2019 09:24 Generated 07/28,2019 09:24 by PsyD Bureau of Prisons NYM Page 1 ol 1 EFTA00073932

Bureau of Prisons -SENSITIVE BUT UNCLASSIFIED- Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/201953 Sex: M Facility: NYM Date: 07;27/2019 07:14 Provider: PsyD Reg #: 76318-054 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. When interviewed, he stated he still cannot remember what happened in SHU that caused the marks on his neck. He stated that for the 5 days before that he had only slept about 30 minutes each night because of noise in SHU. He stated he is anxious about going back to SHU because he stated he is going back to a place where he had gotten marks on his neck and he does not know why it happened. 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 fFillgenljtaaffIllect. 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 nWIntIgh€14f§tiA9ttifiRrettnaRiffieppropriate behavior. He denied current suicidal or self harm ideation. He stated "I'm a cowaWl'attqa hviimirckot like pain and even does not like when he has to give blood. He agreed to immediately tell VAtflar1difeuV)ale t'65iVriions if he starts to have suicidal or self harm thoughts. He was future orientedoillfiediermatnaeiRmrpAWilrimiglanger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmate Companions if he has these thoughts. Intervention(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 by PsyD on 07/28/2019 09:19 Generated 07/28,2019 09:19 by PsyD Bureau of Prisons NYM Page 1 of 1 EFTA00073933

Bureau of Prisons Psychology Services Clinical Intervention - Clinical Contact **SENSITIVE BUT UNCLASSIFIED** Inmate Name Date of Birth: Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: 07127/2019 07:14 Provider: M Facility: NYM PsyD Reg #: 76318-054 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 When interviewed, he st stated that for the 5 days b he is anxious about going bac neck and he does not know why II cannot remember what happened in SHU that caused the marks on his neck. He e had only slept about 30 minutes each night because of noise in SHU. He stated because he stated he is going back to a place where he had gotten marks on his He said he has an appetite and is eati He sa id is waking up every 1 1/2 hours. He stated he feels dehydrated because he is not drinking enough water bec tated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his t •f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood 1O8Parn§t6of affect. His speech was logical and coherent, with no loosening of associations or tangential ial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were fr4e4heifb WicYliffin any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He Mg -Ip added he does not like pain and even does not like when he has to give blood. e agreed:1'6nm al"and Inmate Companions if he starts to have suicidal or self harm thoughts. Htflik fygeop,sigpiAriA II be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmat= 0 1Qns if he has these thoughts. Intervention(s) Supportive and educative interventions were provided. He was given Turnin 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 rung Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arr be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by PsyD on 07/27/2019 08:16 Generated 07/27/2019 08:16 by PsyD Bureau of Prisons NYM Page 1 of 1 EFTA00073934

Bureau of Prisons -SENSITIVE BUT UNCLASSIFIED- Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01)2011953 Sex: M Facility: NYM Date: 07/27/2019 07:14 Provider: PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentatism 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 When interviewed, he st stated that for the 5 days b he is anxious about going bac neck and he does not know why II cannot remember what happened in SHU that caused the marks on his neck. He e had only slept about 30 minutes each night because of noise in SHU. He stated because he stated he is going back to a place where he had gotten marks on his He said he has an appetite and is eatiNr He sa id is waking up every 1 1/2 hours. He stated he feels dehydrated because he is not drinking enough water bec tated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his t •f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood tellninpt8of affect. His speech was logical and coherent, with no loosening of associations or tangential ial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were PIMA WiliYilffin any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He atopi -ce added he does not like pain and even does not like when he has to give blood. e agreedterm a and Inmate Companions if he starts to have suicidal or self harm thoughts. Fit* #448o siviA%rci II be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmat s if he has these thoughts. Intervention(s) Supportive and educative interventions were provided. He was given Turnin 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 ring Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arr be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by PsyD on 07/27/2019 08:16 Generated 07/27;2019 08:16 by PsyD Bureau of Prisons NYM Page 1 of 1 EFTA00073935

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/27/2019 07:14 Facility: NYM Amendment made to this note by PsyD on 07/28/2019 09:19. Page 105 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A) ; (b)(7)(C) of the Freedom of Information and Privacy Act Bureau of Prisons - NYM EFTA00073936

Bureau of PriSonS -SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01/201953 Sex: M Facility: NYM Date: 07/26/2019 09:09 Provider: PhD/Chief Reg #: 76318-054 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). With regard to the events which lead to his initial placement on suicide watch, inmate Epstein stated he has no memory of the event. He asked to speak with his old cellmate "Nick" to see if he can tell him what happened or see if his memory could be triggered. He remarked. 1 am still trying to figure out how I got this (pointing to the scab around his neck)." Inmate Epstein denies remembering harming himself and/or being harmed by his cellmate. 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, irltigtiot0toplt48 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 hirrWO. held pursuant to exemption While on psychological observation, inmate Epstein (PanleA)67dilkAPAPh9s. sleeping and interacting with the inmate companions. He is in legal visiting the aiiifilitya8,9, yhyrtiewridsgrycgpight AVog 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. interventioks) 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. He continues to be vague and reports memory deficits regarding the events which lead to a piece of sheet being placed loosely around his neck and marks with scabs around his neck. Completed by PhD/Chief Psychologist on 07/26/2019 10:05 Generated 07/26;2019 10:05 by PhD/Chief Bureau of Prisons NYM Page 1 of 1 EFTA00073937

Bureau of Prisons -SENSITIVE BUT UNCLASSIFIED- Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01)2011953 Sex: M Facility: NYM Date: 07/25/2019 10:14 Provider: PhD/Chief Reg #: 76318-054 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. He continues to assert he does not remember how he received marks around his neck, remarking "I do not remember anything, maybe you can give me some cues." He stated he just remembers going for a drink of water and the next thing he knew he woke up to the sound of his own snoring. When this writer attempted to get a more detailed account from him, indicating that it would be rare to have 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 missedpl tingsdelme 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 enoupithheld pursuant to exemption Inmate Epstein adamantly denied any suicidality at tAMPOri4,bailet) '1Wlevested in my case to fight it, I have a life and I want to go back to living my life."46igt.%egjAyoiiig rusogogkittrgUpwa. 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. Intervention(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. He has yet to give an account of how he sustained the marks around his neck, is not revealing much about his mental status. and there are concerns about his adjustment at this time to being housed in the SHU. Inmate Epstein will be seen daily by psychology while on psychological observation. Completed by PhD/Chief Psychologist on 07/25/2019 10:43 Generated 07;25,2019 10:43 by PhDiChiel Bureau of Prisons NYM Page 1 of 1 EFTA00073938

Bureau of Prisons Psychology Services Post Suicide Watch Report "SENSITIVE BUT UNCLASSIFIED— Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/24/2019 09:23 Provider: Reg It: 76318-054 M Facility: NYM Unit Team: 5 Ph.D. 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 Watch Stop Date: 07'24,2019 08:45 Transfered to Medical Center: No 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 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 pagifigggiotiaoleeping 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 stWiffhnftOttlarEOPIOniclnefOl4k95brience suicidal ideation or psychological distress. He also denied thoughts of harming others. (b)(6) ; (b)(7)(A); (b)(7)(C) Risk Factors Assessed- This writer screened the inmate for a variety0efrfrfifItititgiaeteteffiefee0erthowikstsociated 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 Risk Factors: Mr. EPSTEIN has a significant scar around his neck. which is now scabbing over. He reported swelling in this area but denied experiencing any related pain. Mr. EPSTEIN continues to claim a lack of memory for the incident resulting in this scar. The story he provided was vague, such that this writer challenged him a couple of times, but he insisted he was being honest about his lapse in memory. The nature of the incident remain unclear. Mr. EPSTEIN is incarcerated for a very high profile crime with media attention. He was recently denied bail. He also reported difficulty managing his time in the SHU. He reported being fearful for his safety if he is to return to the cell with his previous cell mate. 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, in light of his vague self-report regarding the incident which precipitated his placement on Suicide Watch, combined with his fear for his own safety, reported Generated 07124/2019 12:09 by Ph.D. Bureau of Prisons NA/ Page 1 of 3 EFTA00073939

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: Ph.D. difficulty managing his time in the SHU. and 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. Asked about the alleged incident which transpired yesterday resulting in his placement on Suicide Watch. Mr. EPSTEIN said he is frustrated he has been placed in a "punishment cell for no reason." Specifically, Mr. EPSTEIN was referring to his placement in the SHU. Asked to recall the events surrounding the alleged incident. Mr. EPSTEIN said his cell mate was "playing with a bed sheet" and he claimed he does not recall the events thereafter. He said he recalled eating meat and drinking water and claimed the next event for which he has memory is his hearing himself snore and waking up on a stretcher. Mr. EPSTEIN claimed he does not recall himself or his cell mate tying a string or rope around his neck. He said he has "been trying to remember" and "wracking his mind." Asked if he experienced any interpersonal issues with his cell mate. Mr. EPSTEIN described his cell mate as "agitated" and claimed his cell mate called him a "pedophile" for the first time yesterday. His cell mate was also reportedly reading a newspaper article about Mr. EPSTEIN, which bothered him and it was something he believed to be "strange" for their to lignonout him in his cell. Mr. EPSTEIN recalled throwing away the newspaper photograph of himself by trump i it and flushing it down the toilet. Asked if his cell mate ever threatened to harm him, he denied this Withfiekercum antiiptaton told the inmate companions yesterday his cell mate tried to kill him, while also claiming no memory of the incident, Mr. EPSTEIN again said he did not recall the incident and further stated. "I don't know if he put Iteifilecito(a)AelbX4)(EPSTEIN explained he had been experiencing difficulty sleeping in his SHU cell due to his inmate peers banging on the cell door and window, but has not been experiencing any other acute issu4 81SirrciORWIf. Information and Privacy Act 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 ihisl 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 Dx - Current Conclusions The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent Recommendations 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 07124/2019 12:09 by Ph.D. Bureau of Prisons Page 2 of 3 EFTA00073940

Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/24/2019 09:23 Provider: Reg #: 76318-054 M Facility: NYM Unit Team: 5 Ph.D. Observation. 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 by Ph.D. on 07/24/2019 12:09 Page 110 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A) ; (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07/24/2019 12:09 by Ph.D. Bureau of Prisons NYM Page 3 of 3 EFTA00073941

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED'. Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facilit : NYM Date: 07/23/2019 10:09 Provider: PsyD Reg #: 76318-054 Unit Team: 5 Type of Housing: SHU- Administrative Segregation Cell Accommodation: Double-Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview. Medical Record. Psychology Data System, Sentry EteassaLtQLEtetertal The On Call Psychologist. Dr. had been contacted by the Operations Lt. at about 2 AM on 7/23/19 to inform her that Mr. Epstein was being placed on Suicide Watch because he was found with a string around his neck. Mr. Epstein was seen by this writer for a Suicide Risk Assessment at about 9:10 AM on 7/23/19. This note is being entered at about 3:35 PM on 7/23/19. Mental Health History According to a Suicide Risk Assessment dated 7/09/19 by Dr. "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 Page 111 of 148 vii. According to a Suicide Risk Assessment dated 7/09/19 by Dr. , "Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ev*VinicA frY8Smpts or self-injurious behavior in the past." (b)(6) ; (b)(7)(A) ; (b)(7)(C) Substance Abuse History According to a Suicide Risk Assessm6gtttitkre tiA9691(401547.10ffirrihF4tAceOthin denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol." Current Problem Earlier this morning Mr. Epstein was found by SHU staff in his cell with a string loosely tied around his neck. It is unclear at this time if Mr. Epstein had placed the string around his own neck. When Mr. Epstein was asked by this writer how he ended up on Suicide Watch, he denied remembering. He stated he got a drink of water last night in his cell and went back to bed. He said the next thing he remembered is hearing himself snore. He said he wants to know why he is on Suicide Watch. He was informed that staff stated he was found in his cell with a string on his neck. According to Medical records, he had been seen by Medical for this and had a rule out of self inflicted injuries. When this writer reviewed the Staff Suicide Watch Log. it noted that Mr. Epstein told the staff watching him that his cellmate tried to kill him. which Mr. Epstein did not tell this writer when this writer had interviewed Mr. Epstein. This writer was not able to ask Mr. Epstein about this. since Mr. Epstein was now in Legal. The Captain was notified about this notation and the Captain stated they were already aware of this statement. CstrientMental Status Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Generated 07/23/2019 15:38 by PsyD Bureau of Prisons NYM Page 1 of 3 EFTA00073942

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facilit : NYM Date: 07/23/2019 10:09 Provider: PsyD Reg #: 76318-054 Unit Team: 5 Thought Process: Goal Directed Thought Content: Normal 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 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. 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: 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 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 Risk Factors: He was found by staff in his cell in SHU with a string loosely tied around his neck, which Mr. Epstein stated he did not remember anything about. It is unclear at this time if Mr. Epstein had placed the string around his own neck or if someone else did. According to Medical, he had a circular line around the base of his neck, which he denied knowing how he obtained. He stated his throat hurts which was reported to Medical. He 1PaligS tlibWrlili% sex offense case and recently was denied bail. When asked if he has any friends or family that are motionallv sKortive. he stated he does not know what that means. When nneio DUES nt to exemption emotional supports were explained to him and then again asked e as any tamiiy or friends that are emotionally supportive. he was vague and said he has a lot of people. (b)(6): (b)(7)(A); (b)(7)(C) Protective Factors: He denied current suiciblbefealtIbirof eadiRntreimAkiese thoughts. He denied a history of self harm and suicide attempts. He denied a family history of suicidal and self harm attempts. He denied having any chronic medical conditions. He denied feeling hopeless. He denied a history of childhood abuse. He denied fearing for his safety. He denied feeling like a burden to anyone. He reported he is sleeping adequately. He stated he lives to have fun, to enjoy life, and to learn. He said his future plans include fighting his case and going back to his normal life. Whereas, he is denying suicidal and self harm thoughts and has a lot of protective factors, he is denying that he remembers how he ended up on Suicide Watch and has marks encircling his neck. It is unclear at this time if he had placed the string around his neck or if someone else did. He will remain on Suicide Watch for further observation and safekeeping. DIAGNOSIS: No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Moderate Overall Chronic Suicide Risk for this Inmate is: Absent RECOMMENDATIONS 1. Mr. Epstein will remain on Suicide Watch for further observation and safekeeping. 2. While on Suicide Watch, he will be continuously observed by Inmate Companions. 3. While on Suicide Watch, he will be seen daily by Psychology. 4. Supportive and educative interventions were provided. 5. Medical was informed that he reported his throat hurts. Suicide Watch: A suicide watch was initiated by non-clinical staff and continues to be warranted Suicide Watch was initiated on: 07/23/2019 01:40 Generated 07/23/2019 15:38 by PsyD Bureau of Prisons NYM Page 2 of 3 EFTA00073943

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facilit : NYM Date: 07/23/2019 10:09 Provider: PsyD Reg #: 76318-054 Unit Team: 5 Completed by PsyD on 07/23/2019 15:38 Page 113 of 148 Withheld pursuant to exemption (b)(6) ; (b)(7)(A); (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07/23/2019 15:38 by PsyD Bureau of Prisons NYM Page 3 of 3 EFTA00073944

Bureau of Prisons Psychology Services General Administrative Note - SENSITIVE BUT UNCLASSIFIED** Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01;20,1953 Sex: M Facility: NYM Date: 07;23/2019 07:56 Provider: PhD/Chief Reg #: 76318-054 Unit Team: 5 Comments This On-Call Psychologist was contacted by the Operations Lt. at about 2 AM on 7/23/19 to inform Mr. Epstein was being placed on Suicide Watch because he was found with a string loosely hanging around his neck. Mr. Epstein will be seen today by the duty psychologist for a Suicide Risk Assessment. Completed by PhD/Chief Psychologist on 07/24/2019 07:59 Page 114 of 148 Withheld pursuant to exemption (b)(6); (b)(7)(A): (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07/24/2019 07:59 by PhD/Chief Bureau of Prisons NYM Page 1 of 1 EFTA00073945

Bureau of Prisons Psychology Services SHU Review "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: 07/18/2019 07:21 Provider: PhD Chef Placed in SHU: 07/10/2019 Type: SHU Status: ADMIN.DETENTION Threat to Self: Low Basis of Review: Inmate was interviewed Adjustment: Satisfactory, segregation not detrimental Mental Status: No significant mental health issues. Threat to Others: Low Comments Monthly SHU Review Note 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 by PhD/Chief Psychologist on 07/18/2019 12:06 Page 115 of 148 Withheld pursuant to exemption (b)(6); (b)(7)(A) (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07/1812019 12:06 by PhD/Chief Bureau of Prisons NYM Page 1 of 1 EFTA00073946

Bureau of Prisons -SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01)201953 Sex: M Facility: NYM Date: 07116/2019 12:48 Provider: PhD!Chief Reg #: 76318-054 Unit Team: MO 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. Intervention(a) 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 ttPagghlifeoP90ehology 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. Withheld pursuant to exemption Completed by PhD/Chief Psychologist on dia.){§)26WM5(b)(7)(C) of the Freedom of Information and Privacy Act Generated 07118/2019 13:05 by PhD/Chief Bureau of Prisons NYM Page 1 of 1 EFTA00073947

Bureau of Prisons -SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01120,1953 Sex: M Facility: NYM Date: 07111/2019 15:21 Provider: PhD/Chief Reg St: 76318-054 Unit Team: MO Focus of Session Inmate Epstein was seen for his psychological observation follow-up in attorney conference this afternoon. Subie_ctive/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. Inmate Epstein stated he is not having any current problems with his cellmate and indicated he at bran cereal for breakfast and took a shower yesterday. 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. Intervention(s) Inmate EPSTEIN was provided with brief supportive interventions, CBT-based interventions, and psychoeducation regarding additional coping strategies. Inmate EPSTEIN waoaraatitivef tfaese interventions. Progress/Plan ...... Inmate EPSTEIN was educated about both rout/ lYg V l n@re lEi gie tnrtt egrd for contacting Psychology staff. He was e reminded of the self-help books and audiotapes avaiiBlialt% Aye(gfr)6tiology department. He will be seen next week after his bail hearing to assess his mental status 'and syc °logical sea /lily. of the Freedom of Information and Privacy Act Completed by PhD/Chief Psychologist on 07/12/2019 07:51 Generated 07/12/2019 07:51 by PhD/Chief Bureau of Prisons NYM Page 1 ol 1 EFTA00073948

Bureau of Prisons Psychology Services General Administrative Note **SENSITIVE BUT UNCLASSIFIED** Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20r1953 Sex: M Facility: NYM Date: 07;11/2019 14:28 Provider: PsyD Reg St: 76318-054 Unit Team: MO Comments 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 by Imen Darlene PsyD on 07/11/2019 15:51 Page 118 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A); (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07/11/2019 15:51 by PsyD Bureau of Prisons NYM Page 1 of 1 EFTA00073949

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED- Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01)201953 Sex: M Facility: NYM Date: 07;10,2019 08:38 Provider: PhD/Chief Reg #: 76318-054 Unit Team: MO Focus of Session Inmate Epstein was seen today for a psychological observation contact in the hospital area by this writer. Subjective/Obj€ctive 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. Intervention(s) Inmate Epstein was provided with supportive intervention aglco4i4 st yostrategies today. He was receptive to interventions and was able to elucidate his various needs. Hand noPpresent with any acute psychopathology and continues to deny any suicidal ideation. intentionAftiNglatki6iftrthigwdRoywii 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 (b)(6), (b)(7)(A), (b)(7)(C) Inmate Epstein is not in any psychologi 443F@€EOFIPiSfIRf2SrRf8 )3wdh°f7Pjfcgla@tat 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 by PhD/Chief Psychologist on 07/10/2019 09:09 Generated 07/10/2019 09:09 by PhD/Chief Bureau of Prisons NYM Page I of I EFTA00073950

Bureau of Prisons -SENSITIVE BUT UNCLASSIFIED- Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 0112011953 Sex: M Facility: NYM Date: 07109(2019 10:13 Provider: PhD/Chief Reg #: 76318-054 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 anPdSWetPoifelihtit suicidality at this time. He has never received inpatient or outpatient mental health treWiNgorAyagg4AKANaof 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. CO%) AfhttiNje)iffigekytychan 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 of the Freedom of Information and Privacy Act 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 Dx - Current Completed by PhD/Chief Psychologist on 07/09/2019 10:40 Generated 07109,2019 10:40 by PhD/Chief Bureau of Prisons NYM Page 1 of 1 EFTA00073951

Bureau of Prisons Psychology Services Diagnostic and Care Level Formulation "SENSITIVE BUT UNCLASSIFIED** Inmate Name Date of Birth: Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: 07109/201910:13 Provider: M Facility: NYM PhD/Chief Reg #: 76318-054 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,past. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink Inmate Epstein was seen health items or symptoms on h Epstein has various risk factors charges, pre-trial status, and he had legal situation. Inmate Epstein return psychologist. Inmate Epstein was placed on interview him this morning to conduct a fo suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health proble received inpatient or outpatient mental health tre exhibit any acute psychopathology, is currently pt icittg c being classified as a CC1-MH inmate at this time. WM: mental illness (Axis I "No Diagnosis") or is mildly ill and requires Care Level Formulation of the Freedom of Information .sk assessment today for precautionary reasons. He did not mark any mental ology Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate y including a high profile case with media attention, sex offense/trafficking proceeding yesterday which could have given him bad news regarding his om courtier duty hours yesterday evening and staff notified the on-call onary psychological observation status until psychology could risk assessment to determine whether he is currently at-risk for i felAbit suicidality at this time. He has never gaahof suicidality. Currently, he does not nd is in no psychological distress. As such, he is (gan inmate who either has no identifiable ention on an as-needed basis. CARE1-MH is indicative of an inmate who shows no significant level of illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis. No Dx - Current Completed by PhD/Chief Psychologist on 07/09/2019 10:32 airment associated with a mental Generated 07109,2019 10:32 by PhOiChiel Bureau of Prisons NYM Page 1 ol 1 EFTA00073952

Bureau of Prisons Psychology Services Diagnostic and Care Level Formulation **SENSITIVE BUT UNCLASSIFIED" Inmate Name Date of Birth: Date: EPSTEIN, JEFFREY EDWARD 01)201953 Sex: 07109/201910:13 Provider: Facility: NYM PhD/Chief Reg #: 76318-054 Unit Team: MO 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,past. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink Presenting Problem/ 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 om court ter duty hours yesterday evening and staff notified the on-call psychologist. Inmate Epstein was placed on onary 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 received inpatient or outpatient mental health tre exhibit any acute psychopathology, is currently pt ictiog c being classified as a CC1-MH inmate at this time. CMS): mental illness (Axis I "No Diagnosis") or is mildly ill and requires Care Level Formulation of the Freedom of Information CARE1-MH is indicative of an inmate who shows no significant level of illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis. No Dx - Current Completed by PhD/Chief Psychologist on 07/09/2019 10:32 12-ao9felikit suicidality at this time. He has never gagiyisfiof suicidality. Currently. he does not nd is in no psychological distress. As such, he is Man inmate who either has no identifiable ention on an as-needed basis. airment associated with a mental Generated 07/09/2019 10:32 by PhD/Chief Bureau of Prisons NYM Page 1 of 1 EFTA00073953

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 10:13 Facility: NYM Amendment made to this note by PhD/Chief Psychologist on 07/09/2019 10:40. Page 123 of 148 Withheld pursuant to exemption (b)(6) ; (b)(7)(A); (b)(7)(C) of the Freedom of Information and Privacy Act Bureau of Prisons NYM EFTA00073954

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: PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell EltiifiNaS 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 IIII 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 intprekjievitaittlikanorning to conduct a suicide risk assessment. Developmental History Withheld pursuant to exemption Inmate Epstein denied any history of being the victim and/or perpetrator or physical or sexual abuse. Educational History/Cognitive Impairment (b)(6) ; (b)(7)(A); (b)(7)(C) Inmate Epstein reported he obtained V kigtetApiRf8a-affie,RtMollictfgefttoraduate classes in the area of mathematics. Arrest History_and_EXPerience olJacar_caration 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. SatItUiblQnt 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 by Miller, Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 3 EFTA00073955

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: PhD/Chief Psychologist 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 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 preserIbiawlimmitre 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 Wiihttel;f4 NrwaArip. exemption The following PROTECTIVE factors were assessed to tokeyppiymAyNtafc)twase 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 liGtthe Freedom of Information and Privacy Act 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 Dx - Current Generated 07/10/2019 09:20 by PhaChiet Bureau of Prisons NYM Page 2 of 3 EFTA00073956

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg 11: 76318-054 Date of Birth: 01/20/1953 Sex: M Fa ilit : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent 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 by PhD/Chief Psychologist on 07/10/2019 09:20 Page 126 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A) (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07/10/2019 09:20 by PhD/Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00073957

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: MO Date: 07/09/2019 08:41 Provider: 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 on 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 f e risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at thi ' ing 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 s well 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 Inmate Epstein denied any history of being the victim Ma? physical or sexual abuse. Educational History/Cognitive Impairment Withheld o exemption Inmate Epstein reported he obtained his high scho%citgl4 drme graduate classes in the area of mathematics. Arrest History and Experience of toMatheedom of Information Inmate Epstein reported he has served time in Palm Beach County jail apse charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History O Inmate Epstein denied any history of mental health treatment, either on an inpat tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d I 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 a ging 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 Canaeini 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 PhD/Chief Bureau of Prisons - NYM Page 1 of 3 EFTA00073958

Inmate Name Date of Birth: Date: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O 07/09/2019 08:41 Provider: 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 appropri and volume. His thoughts irrelevant content. There not engage in any bizarre or ina explicitly denied recent and curre commitment to life and safety, agree' 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, nized and coherent, with no loosening of associations or tangential. circumstantial. or 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 act staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS SSED• This writer screened the inmate for a variety of suicide. The following STATIC risk factors were assessed t behaviors: High Profile Crime, Lack of family connect Of the DYNAMIC risk factors assessed, none were foun validated factors commonly associated with risk for self-harm and and increase the inmate's risk for engaging in suicide related ender status g of 148 The following PROTECTIVE factors were assessed \41.0 Ilse the inmate's risk of suicide:Able to identify reasons to live. Adequate problem solving skills. Denial of suici. ntion/plans. Future orientation, View of death as negative. Willingness to engage in treatment (b)(6): ( As noted above, Inmate Epstein is a 66-yeartotcrraddtaieAt trgolen factors for suicidality at this time including a high profile case with extensive media attention, sex offense/tr- rges. pre-trial status. and he had a court proceeding yesterday which may have given him bad news regarding his leg Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not hav Cl ationship with. Despite these risk factors, inmate Epstein possesses a number of protective factors atRii Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requeste call, to meet with his attorney. to take a shower, and to brush his teeth. He was eating his cereal when this writ d said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is go g t sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "bei 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 Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Overall Chronic Suicide Risk for this Inmate is: Low Absent Generated 07109i2019 10:36 by PhaChiel Bureau of Prisons NYM Page 2 of 3 EFTA00073959

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg /t: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/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 by PhD/Chief Psychologist on 07/09/2019 10:36 ti e 129 of 148 p° Withheld exemption (b)(6): (b) ) , ( )(C) of the Freedom of Information Generated 07/09,2019 10:36 by PhD/Chief Bureau of Prisons NYM Page 3 of 3 EFTA00073960

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: 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 on 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 thi ing 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 s well 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 Inmate Epstein denied any history of being the victim n arifilfcatg physical or sexual abuse. Educational History/Cognitive Impairment Withheld exemption Inmate Epstein reported he obtained his high scholbrikie a me graduate classes in the area of mathematics. Arrest History and Experience of Incanteisatilanpdom of Information Inmate Epstein reported he has served time in Palm Beach County jail apse charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History 45 Inmate Epstein denied any history of mental health treatment, either on an inpat t ) ient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d 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 ging 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 PhD/Chief Bureau of Prisons NYM Page 1 of 3 EFTA00073961

Inmate Name Date of Birth: Date: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O 07/09/2019 08:41 Provider: 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 appropri and volume. His thoughts irrelevant content. There not engage in any bizarre or ina explicitly denied recent and curre commitment to life and safety, agree' 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, nized and coherent, with no loosening of associations or tangential. circumstantial, or 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 act staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS SSED• 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 e t and increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime. Lack of family connect' s, ender status Of the DYNAMIC risk factors assessed, none were foun it. 148 The following PROTECTIVE factors were assessedWil :Gse 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 (b)(6) (b) (C) As noted above. Inmate Epstein is a 66-yesflitidIrceaddrAidifilftlattn factors for suicidality at this time including a high profile case with extensive media attention. sex offense/tr rges. pre-trial status. and he had a court proceeding yesterday which may have given him bad news regarding his leg Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not hav Cl tionship with. Despite these risk factors, inmate Epstein possesses a number of protective factors atRfi Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requeste call, to meet with his 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 spoon here." He reported he is going to have a bail hearing on Monday and believes he is go g t sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "bei 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 Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent Generated 07/09,2019 10:36 by PhaChiel Bureau of Prisons NYM Page 2 of 3 EFTA00073962

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg Et: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/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 by PhD/Chief Psychologist on 07/09/2019 10:36 e 132 of 148 Withheld • exemption (b)(6) ; (b) )(C) of the Freedom of Information Generated 07/09/2019 10:36 by PhD/Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00073963

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 08:41 Facility: NYM Amendment made to this note by PhD/Chief Psychologist on 07/10/2019 09:20. Page 133 of 148 Withheld pursuant to exemption (b)(6) ; (b)(7)(A) ; (b)(7)(C) of the Freedom of Information and Privacy Act Bureau of Prisons - NYM EFTA00073964

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01120(1953 Sex: M Facility: NYM Date: 07/08/2019 10:41 Provider: PhD/Chief Reg St: 76318-054 Unit Team: MO Comments This writer consulted with Dr. , 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 otentially be giving him bad news regarding his legal situation. As such, when inmate Epstein returns from court. 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 by PhD/Chief Psychologist on 07/08/2019 10:49 Page 134 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A) (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07/08/2019 10:49 by PhD/Chiel Bureau of Prisons NYM Page 1 ol 1 EFTA00073965

Bureau of Prisons Psychology Services Risk of Sexual Abusiveness "SENSITIVE BUT UNCLASSIFIED— Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01!20'1953 Sex: M Facility: NYM Date: 07108:2019 09:35 Provider: PsyD/PhD Reg #: 76318-054 Unit Team: MO Comments Risk of Sexual Abusiveness 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 Page 135 of 148 ( X ) History of prior prison sexual predation withheld pursuant to exemption ( ) History of head injury with loss of consciousness ( ) History of childhood psychological, physical. sexi yM(7)(A) (b)(7)(C) ( ) Witnessed family violence ( ) Antisocial Personality Disorder traitspfltielfebildrogilnieivnatiorsarrctiRrietttgsittoess ( ) 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 staffs 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 P5324.11 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 tol declined programming recommendations. Generated 07/08/2019 09:41 by PsyD.'PhD Bureau of Prisons NYM Page 1 ol 2 EFTA00073966

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/08/2019 09:35 Provider: PsyD/PhD Reg #: 76318-054 Unit Team: A&O Completed by PsyD/PhD on 07/08/2019 09:41 Page 136 of 148 Withheld pursuant to exemption (b)(6) ; (b)(7)(A) ; (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07108/2019 09:41 by PsyD/PhD Bureau of Prisons - NYM Page 2 of 2 EFTA00073967

Bureau of Prisons Psychology Services Intake Screening "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: 07/08/2019 09:24 Provider: . PsyD/PhD Limits of Confidentiality 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. Page 137 of 148 No history of sexual predation in a correctional sltigigawied rsuant to exemption Relevant Psychosocial History Noteworthy psychosocial issues: Other. (b)(6) ; (b)(7)(A); (b)(7)(C) Inmate Epstein is currently incarcerAtchd U oex Toff4king. Ft spoiled he wap previously incarcerated three months for prostitution. Inmate Epstein statedWI! 0;1p &918 d8bITSARAIViy%Rfreft. 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. Inmate Brown 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 07/09,2019 09:30 by PsyDiPhD Bureau of Prisons NYM Page 1 of 2 EFTA00073968

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team: A8O Date: 07/08/2019 09:24 Provider: . PsyD/PhD 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 by . PsyD/PhD on 07/08/2019 09:30 Page 138 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A); (b)(7)(C) of the Freedom of Information and Privacy Act Generated 07108:2019 09:30 by PsyDiPhD Bureau of Prisons NYM Page 2 of 2 EFTA00073969

Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 ••• Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Collected 07/09/2019 13:34 Order Unit E06-547U Received 07/10/2019 10:44 Provider MD Reported 07/10/2019 14:46 LIS ID 188191004 CHEMISTRY Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IDMS) 137 4.7 99 27 17 1.05 >60 137-148 3.5.5.0 99.114 22-30 7.22 0.66.1.25 mmol/L mmol/L mmol/L mmol/L mg/dL mg/dL GFR units measured as mUmini1.73 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 8.5-10.9 mg/dL Glucose 102 70.110 mg/dL AST H 57 11.55 U/L ALT 62 Page 139 of 148 11-66 U/L Alkaline Phosphatase 64 41.133 U/L Bilirubin, Total Withheld pursuant to exemption 0.2.1.3 mg/dL Total Protein 77 6.0-8.2 g/dL Albumin (b)(6?; (b)(7)(A) ; (b)(7)(C) 4.4 3.6.5.1 g/dL Globulin of the Freedom otlaformation and Privacy Act 2.0.3.7 g/dL Alb/Glob Ratio 1.50 1.00-2.30 Anion Gap 10.2 9.0.19.0 BUN/Creat Ratio 16.1 5.0.30.0 Cholesterol H 216 <200 mg/dL Triglycerides H 413 10-150 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 H 6.9 0.0.4.0 HEMATOLOGY WBC 7.6 4.3-11.1 K/uL NRBC% 0.0 RBC 5.42 4.46-5.78 M/uL Hemoglobin 15.6 13.6-17.6 g/dL Hematocrit 47.8 40.2-51.4 MCV 88.2 82.5-96.5 fL MCH 28.8 27.1-34.9 Pg MCHC L 32.6 33.0-37.0 g/dL RDW-CV 12.8 12.0-14.0 Platelet 338 130-374 K/uL FLAG LEGEND L=Low LI=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 1 of 3 EFTA00073970

Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 •" Sensitive But Unclassified ••• Name EPSTEIN. JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order Unit E06-547U Provider MD Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07/10/2019 14:46 LIS ID 188191004 HEMATOLOGY MPV 10.4 6.9-10.5 fL Neutrophils 58.7 Therapeutic decision mak ng should be based on absolute values, rather than percentages Lymphocytes % 25.0 Monocytes % 11.1 Eosinophils % 4.1 Basophils % 0.8 Immature Granulocytes % 0.3 0.0-5.0 % Neutrophils # 4.4 1.9-6.7 K/uL Lymphocytes # 1.9 1.3-3.7 K/uL Monocytes # 0.8 0.3-1.1 K/uL Eosinophils # 0.3 0.0-0.5 K/uL Basophils # 0.1 Page 140 of 148 0.0-0.1 KJuL Immature Granulocytes # 0.02 0.00-0.50 10^3/uL Withheld pursuant to exemption HEMNI-Pf#4081A(7)(c) Hemoglobin A1C 5.7 6.4 Increased Risk H 6.3 of the Freedom of Information and Privacy Act <5.7 > 6.4 Diabetes IPR SEROLOGY Non-Reactive Results may be affected in patients with severely advanced immunosuppression. Non-Reactive FLAG LEGEND L=Low LI=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 2 of 3 EFTA00073971

Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield. MO 65807 417-874-1621 "' Sensitive But Unclassified "' Name EPSTEIN. JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order Unit E06-547U Provider MD Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07/10/2019 14:46 LIS ID 188191004 HIV HIV 1/2 Negative Screening test - See confirmatory testing for Reactive results Page 141 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A); (b)(7)(C) of the Freedom of Information and Privacy Act Negative FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 3 of 3 EFTA00073972

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/10/2019 16:58 Provider: Lab Result Receive Facility: NYM Cosigned by on 07/14/2019 18:12. Page 142 of 148 Withheld pursuant to exemption (b)(6) ; (b)(7)(A); (b)(7)(C) of the Freedom of Information and Privacy Act Bureau of Prisons NYM EFTA00073973

8P-A.0469 JUN 10 U.S. DEPARTMENT OF JUSTICE I-UV COUNSELING DOCUMENTATION FEDERAL BUREAU OF PRISONS Directions: Use the following criteria to counsel the patient who is tested for the HIV anibody. Check off each item as they are discussed. Write NA beside any item that is inappropriate to the situation. Thereverse side of this form will be utilized to document seronegative and inconclusive test result. Then file in the patient's reco rd, documenting in progreis notes that counseling was completed. PRETEST: Y e 1. Explain purpose of session. 2. Explain..confidentiality. . 3. Explain HIV antibody test. a. What HIV is b. What the test is T Test Procedure c. Meaning of test results _de.. f. q. Potential need for additional testing Inability of detecting early infection (false negatives) Significance of a positive test. _, , 4. Ust risk factors/clinical signs: (check all that apply) Injecting drug use, sharing drug or tattoo equipment — b.. • d. e. f. q. Clinical sts: fever or illness oMilikhOISIINUOMIltitjirftlIfitenklf AIDS opportunistic. infections. Pregnant female Other. Exposure: recent occupational or non-occupational exposure/incldent, i (b)(6); (b)(7)(A); (b)(7)(C) . , A Unprotected or multiple sex partners Page 143 of 148 Treated for sexually transmitted infections, hepatitis, or TB of the rreedom of intormaticirrand KiVaty Mr - ----6. • Obtain informed consent (when applicable). . ___ -.6. Risk Reduction Behaviors. Educational material given. /7. Patient ReactionslComments. Explain how the patient will be notified of the result. The above information has been explained to m,e in a language I can understand. SignatUre of Inmate ^ .. Signature of Staff uunseloci ,Se S ,N,Q0 Date: Institution: File in tty$Medical Record: Section 6. Prescribed by P6190 Replaces OPS489.061 &APR 4 EFTA00073974

BP-S359.060 MEDICAL TREATMENT IEFUSAL CDFRM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-9-2019 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: Rectal and genital examination The following treatment(s) was/were recommended: Rectal and genital examination Page 144 of 148 Withheld pursuant to exemption (b)(6): (b)(7)(A) : (+7)(C) Federal Bureau of Prisons Medical sta n ffinembers,ha.ve carefully.explaiged to me that the following 9iOn possible consequences and/or cor Eifi V9gCliffecrtFeaWiyibfusal to accept treatment: Undetected and untreated medical condition. 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. Counseled by kmi W.1d:cal Omcc MCC NY Signature of Witness -2019 Date Patient's Signal 7/1/(5 Date NYM-NEW YORK MCC n 14 )5 Date EFTA00073975

BP-S358 06C MEDICAL TREATMENT REFUSAL CDFRM SEP CS U.S DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-24-2019 Date I, JUT:REY 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 treatments) was/were recommended: EYE DOCTOR EVALUATION. Page 145 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A) : (b)(7)(C) Federal Bureau of Prisons Medical nrpaspagsolmf8rFaofAmpixakytiibto me that the following possible consequences andlor 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 andfor 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. ID 7-24-2019 Date NYM--NEW YORK MCC 7re-cie- EFTA00073976

BP-A0618 JUN 16 U.S. DEPARTMENT OF JUSTICE A&O DENTAL EXAMINATION (Initial Clinical Dental Findings) FEDERAL. BUREAU OF PRISONS Occlusion: • N X1 2 3 4 5 9 7 8 0 1011 1213 14 15 18; 32 3 1 1 ! E J 30 29 28 21 28 25 24 23 22 21 20 19 18 17 9 Pa Dental Prostheses at Intake: Yes Type: Age: Condition: Intra-oral Photos Taken: Yes C Instructed how to obtain argent and non-urgent dents: care: Yes: I No: Oral Hygiene: CPITN: Gocd Far Poor 3 3 2- 3 Head & Neck / Soft Tissue: D: M: I F: p 146 of 148 (b)(6): Classification: CLr Pain Scaie: PIO nt to exempt-was.' Tan 09 )(AR/ /115 /1.1"-r2 R SS ‘,G2 21/2 SUU-2- • of the Freedom of Int rr itoye And c2r z.„Aic y t ay. cayoLiA 0.10 set _fe d Radiographs Taken: (DocJrnent findings on A&O encounter) Yes Treatment Polities: None: Radiographs authorized: PAs: IN/s: Panorex-. nt Name: Non-urgent: non-urgent Urgent: Referred to Sick Call: Prophylaxis authorized: Yes  No (Approve: yak 18 months from examination date) £ Dentist nanl 1>Ds ignaturc Block/Stamp: Number: 76 3 IT- os-M PDF Institution: MCC NEW YORK Date: 7-26 Chret Dental Officer MCC New York Prescribed by P6400 Replaces BP-A0618 cf N 10 EFTA00073977

BP-S358 06O MEDICAL TREATMENT REFUSAL CDFRM SEP 05 U.S DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-24-2019 Date I JEFF REY 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 EVALUA HON Page 147 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A) (b)(7)(C) Federal Bureau of Prisons Medical INteWiatfisdP R&M IMUNcrispia,AgiVtto me that the following possible consequences and/or complications may resu t cause of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRLNT OP1HALMOLOGIC 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. 7-24 2310 Cou Date Patient's Sign Dale NYM--NEW YORK MCC EFTA00073978

BP-S358.060 SEP C5 MEDICAL TREATMENT REFUSAL CDFUM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-10-2019 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: 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. The following treatment(s) wasfwere recommended: CHEST X-RAY Page 148 of 148 Withheld pursuant to exemption (b)(6) (b)(7)(A). (b)(7)(C) Federal Bureau of Prisons Medica4 ta7rmyrbgirsntfoiryinr aenfAxvemlained to me that the following possible consequences and/or cSm TicaiTas may resuff because refusal to accept treatment: WORSENING THE CONDITION IF THERE IS ANY FINDINGS 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. . X-RAY 7-10-2019 Counseled by Date Patien Signature Date Signature of Witness NYM-NEW YORK MCC EFTA00073979