WOODSON C. MERRELL, M.D. PLLC 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: (212) 535-1012 Fax: (212) 535-1172 Checklist for New Patient Inquiries Date:

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: (212) 535-1012 Fax: 12 1 21535-1172 Date: September 19, 2016 Patient: Jeffrey E

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: (212) 535-1012 Far (212) 535-1172 Date: October 26, 2010 Patient: Jeffrey Epste

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telt ithon Pax: Date: October 21, 2010 Patient: Jeffrey Epstein (Email: • Try of the fol

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: Far Date: November 18, 2010 Patient: Jeffrey Epstein • Begin vitamin D3 at on

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WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: Far Date: March 4, 2010 Patient: Jeffrey Epstein (Email: Jeffery the following

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: (212) 535-1012 Fax: (212) 535-1172 Date: March 3, 2010 Patient: Jeffrey Epstein

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: (212) 535-1012 Fax: (212) 535-1172 Date: October 26, 2010 Patient: Jeffrey Epst

WOODSON C. MERRELL, M.D. Telephone: Fax: Checklist for New Patient Inquiries Date: 10/10/11 Taken By: Name: Age: 32 DOB: Address: Phone: SS#: Email: Refer

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone. Fax: Date: October 20, 2011 Patient: (Email: • See integrative ENT Dr. Sezell

WOODSON C. MERRELL, ., PLLC 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: (212) 535-1012 Fax: (212) 535-1172 December 11, 2018 Re: Karyna Shuliak (DOB

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: (212) 535-1012 Fax: (212) 535-1172 Date: July 27, 2011 Patient: Jeffrey Epstein

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LE STORE NEW YORK NY $43.50 APPLE STORE NE 01/25/17 S YALE A ROMOFF MD PC 0000 NEW YORK NY $375.00 Description MEDICAL SERVICES 01/30/17 WOODSON C. MERRELL, MD P 0780 NEW YORK NY $775.00 Description MEDICAL SERVICES 02/06/17 VITAHEALTH NEW YORK NY $161.74 212428.1110 Description PRESCUPTIONS

: PASSENGER TICKET YY 00 T1 M YY 00 Date of Departure: 03/22 03/20/17 CET GROUP/ UNITED EXPR NEW YORK NY $192.80 212.965.1010 03/20/17 WOODSON C. MERRELL, MD P 0780 NEW YORK NY $1,035.00 03/21/17 Demotion MEDICAL SERVICES AEROFLOT AMERICAN EXPRES UNITED STATES OF AMER $588.10 AEROFLOT From:

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone Fax: Checklist for New Patient Inquiries Date: Name: Age: DOB: Address: Phone