Suicide Watch Chronological Log Inmate Companions Log © Name of inmate on watch: = .. wv c Epsiem Siem oO 6 Zz Ss $8 = Register #: 2 a eo) = 2 q Wrest 3 Gwe z — =a xs £ £ [oe omar) ¢ Institution: 4 ov % ae =-£ 2 ao 4's wi SHARE Ss ¢ w [s) & E S vo wo oY SePTBSSaal$ Date Watch Began/Ended 73 SBBSawES 2 S535 7 OG ¢ 1/23 }'4 ORAAAGAFY To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - INMATE CONFIDENTIAL SDNY_00010835 . EFTA00139516

--=PAGE_BREAK=--

STAPLE LOCAL PROCEDURES HERE Check one of the following: o This is the initial log book for this suicide watch. Enter date and time watch began: ia) This is a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every minutes. Legibly print and sign your name at the beginning of your shift. CONFIDENTIAL SDNY_00010836 EFTA00139517

--=PAGE_BREAK=--

Suicide Watch Observation Log auth EBSICLA Regt: 14515. 5 | _time | __ observations: Bretly note your observations. initial allentries. | _initiats_| == On | Ym Zeca vt a o Succi &e ceil Fi MS; — Jind a Ga Cul! 4c 4 Tene Tt. ke 7" matt 12d r(f aA __ 5b | lm iMag om be) ured — What Happen —_— 4) wu i (hs 36 — rv * wa _| Ton i Hytq em Bed ——— 2 4 Sun 7 Andes fakes pictues cf ilu |B Mme | fm Gi ting yn EO AS Sted Ses fn [Ye Sey en Bed i A 2 a Note to all observers: Legibly print and sign your name at the beginning of your shift. SDNY_00010837 CONFIDENTIAL EFTA00139518

--=PAGE_BREAK=--

Suicide Watch ono! hOG:,! Staff Suicide Watch « ’ Observers only. Be WS See Oa a fmt . “Institution: Rei, aia Date’ Watch Began | Ended . uly 23,2014 = July 24, oq To be completed by Chief Psychologist at conclusion of watch: _ Booklet of SWCL - STAFF CONFIDENTIAL SDNY_00010838 EFTA00139519

--=PAGE_BREAK=--

STAPLE LOCAL PROCEDURES HERE Check one of the following: a: * This is the initial log book for this suicide watch... Enter date and time watch began: Suly 23,2010 a} 40am O° Thisa continuation log book for this watch. aw Enter date and time this watch book was initiated: ope ee Heh a % \ Instructions to Observer: “3 Document your observations every AG minutes. Legibly print and sign your name at the beginning of your shift. CONFIDENTIAL SDNY_00010839 EFTA00139520

--=PAGE_BREAK=--

COSsIeIN Suicide Watch Observation Log Observations: Briefly note your observations. Initial all entries. iN thy “inmate slonding at dane RY | as, Note to all observers: Legibly print and sign your name at the beginning of your shift. CO N F | DE NTIAL SDNY_00010840 EFTA00139521