EFTA00033966.pdf
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- pdf
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PLEASE RETURN LOG TO PSYCHOLOGY AFTER
THE OBSERVATION HAS ENDED.
THANK YOU.
ITEMS ALLOWED:
Regular Clothes
Safety Toothbrush
Newspaper/Magazine
Books (softcover only)
Safety Pen and Paper
Toilet Paper
Legal Mail
Other
SW Blanket & SW Mattress must be used even on
Psych Observations.
.d If nothing is checked with a silver marker, only a
Suicide Smock and Suicide Blanket are allowed.
(_,UNI- ILJEN I IAL
SDNY 00009719
EFTA00033966
Name of Inmate On Suicide Watch or Psych Observation:
ESErft
PI
Registration U: /031g-O5ti
EATING/SHOWER CHART
DATE
BREAKFAST
LUNCH
46
DINNER
LIQUIDS
OFFERED
SHOWER
RECEIVED
SHOWER '
Please check the appropriate box if the person on
Suicide Watch/Psych Observation actually eats his
meal. Do not check the box if he just received it,
but did not eat it.
Place a check in the "Liquids" box each time the
person drinks.
Thank you.
CONFIDENTIAL
SDNY_00009720
EFTA00033967
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