{
  "document_metadata": {
    "page_number": "2405",
    "document_number": "BP-S358.060",
    "date": "7-24-2019",
    "document_type": "MEDICAL TREATMENT REFUSAL",
    "has_handwriting": true,
    "has_stamps": false
  },
  "full_text": "Page 2405\nBP-S358.060 SEP 05 CDFRM\nMEDICAL TREATMENT REFUSAL\nU.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS\n7-24-2019 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:\nEYE DOCTOR EVALUATION.\nThe following treatment(s) was/were recommended:\nEYE DOCTOR EVALUATION.\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:\nINABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES.\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)] [b(6); (b)(7)(C)] MD 7-24-2019 Date\nCounseled by\n[b(6); (b)(7)(C)] 07/24/19 Date\nSignature of Witnesss [b(6); (b)(7)(C)] 11/25/19 Date\nNYM--NEW YORK MCC\nDOJ-OGR-00026081",
  "text_blocks": [
    {
      "type": "printed",
      "content": "MEDICAL TREATMENT REFUSAL",
      "position": "header"
    },
    {
      "type": "printed",
      "content": "U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS",
      "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": "handwritten",
      "content": "JEFFREY EPSTEIN",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY:",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "EYE DOCTOR EVALUATION.",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "The following treatment(s) was/were recommended:",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "EYE DOCTOR EVALUATION.",
      "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:",
      "position": "body"
    },
    {
      "type": "printed",
      "content": "INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES.",
      "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": "[Signature]",
      "position": "footer"
    },
    {
      "type": "handwritten",
      "content": "MD 7-24-2019",
      "position": "footer"
    },
    {
      "type": "handwritten",
      "content": "07/24/19",
      "position": "footer"
    },
    {
      "type": "handwritten",
      "content": "11/25/19",
      "position": "footer"
    }
  ],
  "entities": {
    "people": [
      "JEFFREY EPSTEIN"
    ],
    "organizations": [
      "U.S. DEPARTMENT OF JUSTICE",
      "FEDERAL BUREAU OF PRISONS"
    ],
    "locations": [
      "NEW YORK MCC"
    ],
    "dates": [
      "7-24-2019",
      "07/24/19",
      "11/25/19"
    ],
    "reference_numbers": [
      "BP-S358.060",
      "76318-054",
      "DOJ-OGR-00026081"
    ]
  },
  "additional_notes": "The document contains redactions of personal information, indicated by [b(6); (b)(7)(C)]. The document is a medical treatment refusal form signed by Jeffrey Epstein."
}