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- {
- "document_metadata": {
- "page_number": "2669",
- "document_number": "BP-S358.060",
- "date": "7-24-2019",
- "document_type": "Medical Treatment Refusal",
- "has_handwriting": true,
- "has_stamps": false
- },
- "full_text": "Page 2669\nBP-S358.060 SEP 05\nMEDICAL TREATMENT REFUSAL CDFRM\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 OPHTHALMOLOGIC 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)] Patient's Signature\n[b(6); (b)(7)(C)] MD 7-24-2019 Date\nCounseled by\n[b(6); (b)(7)(C)] 8/11/19 Signature of Witness Date\nNYM--NEW YORK MCC\nDOJ-OGR-00026325",
- "text_blocks": [
- {
- "type": "printed",
- "content": "Page 2669\nBP-S358.060 SEP 05\nMEDICAL TREATMENT REFUSAL CDFRM\nU.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS",
- "position": "header"
- },
- {
- "type": "printed",
- "content": "7-24-2019 Date",
- "position": "header"
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- {
- "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": "top"
- },
- {
- "type": "printed",
- "content": "DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY:\nEYE DOCTOR EVALUATION.",
- "position": "top"
- },
- {
- "type": "printed",
- "content": "The following treatment(s) was/were recommended:\nEYE DOCTOR EVALUATION.",
- "position": "middle"
- },
- {
- "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": "middle"
- },
- {
- "type": "printed",
- "content": "INABILITY TO DIAGNOSE CURRENT OPHTHALMOLOGIC DISEASES.",
- "position": "middle"
- },
- {
- "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": "middle"
- },
- {
- "type": "handwritten",
- "content": "[b(6); (b)(7)(C)]",
- "position": "bottom"
- },
- {
- "type": "printed",
- "content": "Counseled by",
- "position": "bottom"
- },
- {
- "type": "handwritten",
- "content": "[b(6); (b)(7)(C)] MD 7-24-2019 Date",
- "position": "bottom"
- },
- {
- "type": "handwritten",
- "content": "[b(6); (b)(7)(C)] 8/11/19",
- "position": "bottom"
- },
- {
- "type": "printed",
- "content": "Signature of Witness Date",
- "position": "bottom"
- },
- {
- "type": "handwritten",
- "content": "[b(6); (b)(7)(C)]",
- "position": "bottom"
- },
- {
- "type": "printed",
- "content": "NYM--NEW YORK MCC",
- "position": "footer"
- },
- {
- "type": "printed",
- "content": "DOJ-OGR-00026325",
- "position": "footer"
- }
- ],
- "entities": {
- "people": [
- "JEFFREY EPSTEIN"
- ],
- "organizations": [
- "U.S. DEPARTMENT OF JUSTICE",
- "FEDERAL BUREAU OF PRISONS"
- ],
- "locations": [
- "NEW YORK MCC"
- ],
- "dates": [
- "7-24-2019",
- "8/11/19"
- ],
- "reference_numbers": [
- "BP-S358.060",
- "76318-054",
- "DOJ-OGR-00026325"
- ]
- },
- "additional_notes": "The document contains redactions of personal information."
- }
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