REN-ADR-70

Code
REN-ADR-70
Mercy ID
V-00613-01
Encounter Date
07/24/2001
Last
Rendón
First
Adriana
DOB
03/27/1970
County
Dekalb
Street
2159 Dresden Dr. B
City
Chamblee
State
GA
Zip
30341-
Home
(404) 327-9714
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Bolaños
First
Eugenio
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Cristina Vasquez 03/28/1993 Mother w/Stepfather GA/USA
Elia Vasquez 07/19/1991 Mother w/Stepfather GA/USA
Elizabeth Bulaños 08/05/1996 Parents GA/USA
Isaac Vasquez 12/10/1994 Mother w/Stepfather GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
K. Aleman
Referred By
Walking Mision and on 6/12/02 by x7764 Rebecca