ice Authority Page 3 of 3 EFTA00040025 POD Forms - LISM552 I Page 1 of POt. Corm! • PopeS • I S. Department of Juliet Fete Out :8/8/7018 aged States Marshals kis ice at$MM PRISONER MEDICAL RECORDS RELEASE FORM Dotoetnt Number: 84(6.1" 1 INSTRUCTIONS: Section 1. II & III is to be compkied by the USMS Intake