{
  "document_metadata": {
    "page_number": "2398",
    "document_number": "BP-S358.060",
    "date": "7-10-2019",
    "document_type": "MEDICAL TREATMENT REFUSAL",
    "has_handwriting": true,
    "has_stamps": false
  },
  "full_text": "Page 2398\nBP-S358.060 SEP 05 MEDICAL TREATMENT REFUSAL CDFRM\nU.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS\n7-10-2019 Date\nI, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s):\nDESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY:\n66 YR OLD MALE WITH NO PMHX, REFERRED FOR ROUTINE CXR.\nThe following treatment(s) was/were recommended:\nCHEST X-RAY\nFederal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment:\nWORSENING THE CONDITION IF THERE IS ANY FINDINGS\nI 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.\n(b)(6); (b)(7)(C) 7-10-2019 Patient's Signature\nCounseled by Date\n(b)(6); (b)(7)(C) 7-10-19 NYM-NEW YORK MCC\nSignature of Witness Date\nDOJ-OGR-00026074",
  "text_blocks": [
    {
      "type": "printed",
      "content": "Page 2398\nBP-S358.060 SEP 05 MEDICAL TREATMENT REFUSAL CDFRM\nU.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS",
      "position": "header"
    },
    {
      "type": "printed",
      "content": "7-10-2019 Date",
      "position": "header"
    },
    {
      "type": "printed",
      "content": "I, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s):",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY:\n66 YR OLD MALE WITH NO PMHX, REFERRED FOR ROUTINE CXR.",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "The following treatment(s) was/were recommended:\nCHEST X-RAY",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment:\nWORSENING THE CONDITION IF THERE IS ANY FINDINGS",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "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.",
      "position": "body"
    },
    {
      "type": "handwritten",
      "content": "7-10-19",
      "position": "footer"
    },
    {
      "type": "printed",
      "content": "Counseled by (b)(6); (b)(7)(C) 7-10-2019 Date\nSignature of Witness (b)(6); (b)(7)(C) 7-10-19 Date",
      "position": "footer"
    },
    {
      "type": "signature",
      "content": "Patient's Signature",
      "position": "footer"
    },
    {
      "type": "printed",
      "content": "NYM-NEW YORK MCC",
      "position": "footer"
    },
    {
      "type": "printed",
      "content": "DOJ-OGR-00026074",
      "position": "footer"
    }
  ],
  "entities": {
    "people": [
      "JEFFREY EPSTEIN"
    ],
    "organizations": [
      "U.S. DEPARTMENT OF JUSTICE",
      "FEDERAL BUREAU OF PRISONS",
      "Bureau of Prisons"
    ],
    "locations": [
      "NEW YORK MCC"
    ],
    "dates": [
      "7-10-2019",
      "SEP 05"
    ],
    "reference_numbers": [
      "BP-S358.060",
      "76318-054",
      "DOJ-OGR-00026074"
    ]
  },
  "additional_notes": "The document is a medical treatment refusal form signed by Jeffrey Epstein on 7-10-2019. The form indicates that Epstein refused a recommended chest X-ray treatment. The document contains redactions in the counselor and witness signature blocks."
}