Suicide Watch
Chronological
Log
Inmate Companions Log
Name of inmate on watch:
ONLY ITEMS ALLOWED:
Register #:
Suicide Mattress
GSLI
Institution:
Date Watch Began / Ended
- 1123 19
To be completed by Chief Psychologist at conclusion of
watch:
Booklet of
SWCL - INMATE
CONFIDENTIAL SDNY_00009269
EFTA00033775
STAPLE LOCAL PROCEDURES HERE
Check one of the following:
h.
❑ This is the initial log book for this suicide watc
Enter date and time watch began:
❑ This is a continuation log book for this watch.
ted:
Enter date and time this watch book was initia
Instructions to Observer:
minutes.
Document your observations every
of your shift.
Legibly print and sign your name at the beginning
CONFIDENTIAL SDNY Onnn477n
EFTA00033776
Suicide Watch Observation Log
NameocfhInmate
on wat
34e,, O
Reg #: lci , 5 1 E) 054 Date: —1 25) iq
Time Observations: Briefly note your observations. Initial all entries. Ini lals
: LIO
M Set451A+ )6tve4 AO ct4 Ili LE cell ft
1 "ICAni .tx I& o t., gea
,.,
j.awl 1 VA ( Go l,e_..1 i k I (t t
2 1+4 1-r- I-15 • edl k -4. —I 4 (6 (I
(II
2 " ow km Si C-Fi 4 wl (0? J -ini au ii r.e......4
wk _IAjoe
2 '- ' ( . f4i .4 cmt 3(.6
Avi cif ge b
3.1 CA 4-a fc.ti eic 114-reJ
3:56 CiI-A; A 6( 0
's is, SIFH ?-93
I 106 - a
I cit)
10 WA S 11iv-A- ‘ i shir -6,-(44-
• qr , c.fl‘-,14., Ja la., .4=fi--kit
asui 16 4 n4 W
,LA-- •
L5 Y4-4-t‘._ ti, ("el
ec n kt^- 1•
Sit r Aw' Iti __\ A
414, ei, i 1 froOct/
Note to all observers: Legibly print and sign your name at the beginning of your shift.
1
CONFIDENTIAL SDNY_00009271
EFTA00033777
Suicide Watch
Chronological
Log
Staff Suicide Watch
Observers Only
Name of inmate on watch:
Register #:
(31p)-054
Date Watch Began / Ended
duly 23,201q — . 0 / C1
To be completed by Chief. Psychologist at conclusion of watch:
Booklet of
SWCL - STAFF
CONFIDENTIAL SDNY_00009272
EFTA00033778
STAPLE LOCAL PROCEDURES HERE
Check one of the following:
This is the initial log book for this suicide watch.
Enter date and time watch began:
du l4 23120%q a+ tAom,A
This a continuation log book for this wafdh.
Enier date and time this watch book
Instructions to Observer:
Document your obserVations every 15 minutes.
Legibly print and sign your name at the beginning of your shift.
CONFIDENTIAL SDNY_00009273
EFTA00033779
Ei)4ein Suicide Watch Observation Log
Nam of Inmate
on watch: Reg #: - 4(.051? ) - n54 Date: 1123 In
Time Observations: Briefly note your observations. Initial all entries. Initials
1 4 0 AM Inmck. bro hl- down foSuicicle cell-44
l '.14544 inrnae kiin on bed
ZODAm Inman-e 5f-I-1-iol on bed -I-Olking
2'. i54)4 Inrrok L5ta+e51-1; 5 celirral-e -I-rie(i -i-o v-al h•
2'.3O InrnOk. ,5iViins on bftri 4-ti ins +0 rernernbei-
Whli- hifirperert
2..45 Atvi inrrale oi4-14(1) (X) bed
3 .0DAm • ' cr) bed
3i15A0 ye-, pi C4-ure.5 a i nml
3'.30Am 1NW-4e- 61-Airo on bed
'.-46Am i ninc)+e 6 i 4- it xp on bed
4-•.0oAm Inrrad-e 5l-H1r on htd
4•, SAM 1 nmnk. Lli-i-i-inc) do hfo
4•3:)Ato nreal-e_ ,..5-1(inJ in3 ai- door +0 lkii9
4.-45AM I rynni-e_ 640r1-1'04 door 4-ct 4:1(19
5'. 00Arvi I nmcd-e 5i-Hirn on bed
5:154 I 0 L." (--a d o c14- .scar
5.3DAm nmak. 54-nnot no 04 door
,45ANt Int-na-fe c51-ondin9 (14 door
•-.ozAtvi I ell e ,3-la • S clu-or
co . I5Am Inmoi-e, (5-Ictryiirr\ co- dcor
cp.,30A,4 iniyyli-e a4cird\43 0+ day
V.-4-5Am Irun4e. Olort1ios CH- ()nor
-7% 00 A &A in mcii-e- 640rA in3 a+. GIM'
Note to all observers: Legibly print and sign your name at the beginning of your shift.
CONFIDENTIAL SDNY_00009274
EFTA00033780