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Suicide Prevention Status Orders – RemovalInmate Information Inmate Name: ACOMS#:Suicide Prevention Status FORMCHECKBOX Constant Observation FORMCHECKBOX Close Observation FORMCHECKBOX Modified ObservationDocumentation Reviewed FORMCHECKBOX Suicide Prevention Status Initiation FORMCHECKBOX Incident Report (s) FORMCHECKBOX Cumulative Observations FORMCHECKBOX Medical Records/Electronic Health Record FORMCHECKBOX Other: Justification for Discontinuation FORMCHECKBOX No longer presenting a risk of self-injury. No identified suicide risk observed or reported.Mental Health Recommendations Staff Initiating Suicide Prevention DiscontinuationName: Title: Signature: Date:Superintendent or Designee Review Signature: Date: FORMCHECKBOX Approved FORMCHECKBOX DeniedComments: ................
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