MAY-ADD-77

Code
MAY-ADD-77
Mercy ID
V-00846-01
Encounter Date
02/15/2002
Last
Maya
First
Addy
DOB
05/27/1971
County
Dekalb
Street
2504 Brookville Ave.
City
Doraville
State
GA
Zip
30340-
Home
(678) 291-0308
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical

Spouse Information

Last
Maya
First
Domingo
DOB
09/27/1977
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
No
Consentimiento De Participar
No

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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Carlos Maya 05/24/1997 Parents GA/USA
Fernando Maya 05/09/2001 Parents GA/USA
Julio Cesar Maya 05/21/2000 Parents GA/USA
Saul Maya 02/03/1999 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
Ma. Eugenia x7764