{ "document_metadata": { "page_number": "2500", "document_number": "BP-S358.060", "date": "7-24-2019", "document_type": "MEDICAL TREATMENT REFUSAL", "has_handwriting": true, "has_stamps": false }, "full_text": "Page 2500\nBP-S358.060\nSEP 05\nMEDICAL TREATMENT REFUSAL\nCDFRM\nU.S. DEPARTMENT OF JUSTICE\nFEDERAL BUREAU OF PRISONS\n7-24-2019\nDate\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)\nMD\n7-24-2019\nDate\n(b)(6); (b)(7)(C)\n07/24/19\nDate\nCounseled by\nSignature of Witness\n(b)(6); (b)(7)(C)\n1.5.54\nNYM--NEW YORK MCC\nDOJ-OGR-00026176", "text_blocks": [ { "type": "printed", "content": "Page 2500\nBP-S358.060\nSEP 05\nMEDICAL TREATMENT REFUSAL\nCDFRM\nU.S. DEPARTMENT OF JUSTICE\nFEDERAL BUREAU OF PRISONS", "position": "header" }, { "type": "printed", "content": "7-24-2019\nDate", "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:\nEYE DOCTOR EVALUATION.", "position": "body" }, { "type": "printed", "content": "The following treatment(s) was/were recommended:\nEYE 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": "(b)(6); (b)(7)(C)", "position": "body" }, { "type": "printed", "content": "Counseled by", "position": "footer" }, { "type": "handwritten", "content": "(b)(6); (b)(7)(C)\n07/24/19", "position": "footer" }, { "type": "printed", "content": "Signature of Witness", "position": "footer" }, { "type": "handwritten", "content": "(b)(6); (b)(7)(C)\n1.5.54", "position": "footer" }, { "type": "handwritten", "content": "NYM--NEW YORK MCC", "position": "footer" }, { "type": "printed", "content": "DOJ-OGR-00026176", "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" ], "reference_numbers": [ "BP-S358.060", "76318-054", "DOJ-OGR-00026176" ] }, "additional_notes": "The document contains redactions marked as '(b)(6); (b)(7)(C)' indicating sensitive information has been removed. The document is a medical treatment refusal form signed by Jeffrey Epstein." }