tions, 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 5X re 5 tions. 7-24-2019 unse Date NYM-NEW YORK MCC EFTA00110337 BP-S35

tions, 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. ESGUERRA, S. X-RAY 7-10-2019 Counseled by

ions, 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. BEAUDOUI , ROBERT MD 7-24.2019 Counseled by

ns, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental c • ndition, and release the Bureau of Prisons and Its employees from any and all liability for respecting and •!lowing my expressed wishes and directions. MD 7-24-2019 Counseled by Date Pa l's Sig

ions, 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 Date Signature of Witne ^ Dat

tions, listed above, and still refuse recommended treatment I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and Its employees from any and all liability for respecting and following my expressed wishes and directions. b)/6): (b)(7)1C) 7-24-2019 Date ig~ Date

ions, 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. b)(6), (b)(7)(C) 7-24-2019 Date Date b)(6

ions, 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-

ions, 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. MD 7-24-2019 Counseled by Date c7a,r =M i