GON-ANA-64

Code
GON-ANA-64
Mercy ID
V-00902-01
Encounter Date
04/12/2002
Last
Gonzalez
First
Ana
DOB
11/22/1964
County
Gwinnett
Street
5481 Station Circle
City
Norcross
State
GA
Zip
30071-
Home
(770) 381-6842
Cell
(678) 886-2186
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Chevez
First
Juan
DOB
01/23/1977
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
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
YES
Relative
YES
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Jacqueline Amaya 06/30/2001 N/A GA/USA
Juan Chevez 10/03/1997 N/A GA/USA
Maricela Amaya 07/10/2004 N/A GA/USA
Maritza Cheves 03/19/1999 N/A GA/USA
Orbelina Chevez 11/23/2000 N/A GA/USA
Yami Chevez 12/28/1995 Mother GA/USA
NOTES
*****2008, NO SE CONTACTO, NO A.R.*****

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
x7764 Ma. Eugenia