Epstein File EFTA00313615: East 71st and Personal Assistant (DS9)

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💨IMPACT LEVEL 1 — MEH

Epstein File EFTA00313615: East 71st and Personal Assistant (DS9)

General DocumentDate unavailableEFTA003136151 keyword hits

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This document is a medical authorization and disclosure form for an individual at 9 East 71st Street, New York, NY 10021. The form authorizes disclosure of medical information to a personal assistant named Lesley Groff, also listed at the same East 71st Street address, and includes standard healthcare privacy authorization checkboxes.

👤 Named in This Document

Lesley Groff

🔑 Evidence Keywords

East 71st personal assistant 9 East 71st Street

📋 Key Excerpts4

PersonKeyword

Excerpt 1

.: / / Month/Day/Year Address: 9 **East** **71st** Street, New York, NY 10021 (Street) (City) (State) (Zip Code) Please request/check all that apply: I authorize

Excerpt 2

check one) To Healthcare Provider Insurance Company or Designee Attorney Court Law Enforcement Employer Personal Assistant Other: Name: Lesley Groff 9 **East**

Excerpt 3

**71st** Street, NY, NY 10021 Address: Reason for Disclosure Patient Request Other: We will not condition treatment or payment on whether you sign this authorization