EFTA00033867.pdf

Type: pdf
Source set: data-set-8
Extracted text

Suicide Watch 
Chronological 
Log 
Inmate Companions Log 
Name of inmate on watch: 
Register #: 
Institution: 
Date Watch Began / Ended 
-1123
ONLY ITEMS ALLOWED: 
To be completed by Chief Psychologist at conclusion of watch: 
Booklet 
of 
Suicide Mattress 
CONFIDENTIAL 
SWCL - INMATE 
SDNY_00009534 
EFTA00033867


STAPLE LOCAL PROCEDURES HERE 
Check one of the following: 
K 
This is the initial log book for this suicide watch. 
Enter date and time watch began: 
K 
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 OnnnciS r+ 
EFTA00033868


Suicide Watch Observation Log 
Name of Inmate eip 
i 
on watch: 
s et, 
1 n 
Reg #: 14 , 5 1b• C6 
Date: - 1 25 1 lq 
Time 
Observations: Briefly note your observations. Initial all entries. 
Initials 
I : 14°A;Di 
kiM S."( 5IA+ 
66.4.44 
AO 
ctn it I. 14. Cell 11 4 
A
.-- 
I .L'ICAlin 
1/4.1 AI 
Ilil&l
i
oki 
geo 
...---- 
0 . 
2 "`kwt 
Illy 
1 it 
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I A_ tfriiii 
--- 
,
- 
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cm. 
7,t 7b 
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k 
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Inn, i, i 1) 64 
cti 
Note to all observers: Legibly print and sign your name at the beginning of your shift. 
1 
CONFIDENTIAL 
SDNY_00009536 
EFTA…
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