Medical Record/Request Form: DOJ-OGR-00024155

This document is a modified diet request form for inmate Jeffrey Edward Epstein, detailing various dietary restrictions and requirements, including a noted fish allergy. The form was generated on July 30, 2019, by a health services staff member. It lists several diet types with expiration dates, including a 'FISH ALLERGIES' notation with an expiration date of July 30, 2020.