EFTA00033886.pdf

Type

pdf

Source set

data-set-8

Original source

Extracted text

Suicide Watch 
Chronological 
Log 
Inmate Companions Log 
Name of inmate on watch: 
Er5)-e,Y,
Register #: 
GSLi 
Institution: 
Date Watch Began / Ended 
- 1123 19 
ONLY ITEMS ALLOWED: 
cu 
talc 
• 
c1:1
—
(i) qp 
C 
U 
O 
cp 
E w 
t° 
cr) 
CU 
<1) 
6" 
co :3 
tr) V) V) 
To be completed by Chief Psychologist at conclusion of watch: 
Booklet 
of 
Suicide Mattress 
c 
C 
a 
• 
o 
c 
• 
0 (.1
ca. 
a- 
Q. 
no 0 CO 
a. co t— 
< 
CONFIDENTIAL 
SWCL - INMATE 
SDNY_00009575 
EFTA00033886


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 Onnn457R 
EFTA00033887


Suicide Watch Observation Log 
Name of Inmate ap  l 
on watch: 
s ei, 
1 n 
Reg a: 14, 5 1/3• C6 
Date: —1 25  iq 
Time 
Observations: Briefly note your observations. Initial all entries. 
Initials 
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Note to all observers: Legibly print and sign your name at the beginning of your shift. 
1 
CONFIDENTIAL 
SDNY_00009577 
EF…

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