LOZ-DAM-76

Code
LOZ-DAM-76
Mercy ID
V-00925-01
Encounter Date
05/14/2002
Last
Lozada
First
Damarys
DOB
10/23/1976
County
Gwinnett
Street
2021 Bentleley Dr.
City
Stone mountain
State
GA
Zip
30087-
Home
(770) 469-0411
Family Status
Single parent w/children
COB
Puerto Rico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Rodriguez
First
Juan carlos
DOB
09/04/1972
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
Driver
No
Home Owner
YES
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 Juan Rodriguez 02/25/1996 Mother GA/USA
Joni Rodriguez 10/31/1997 Mother 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
x7764 Ma. Eugenia