RIV-REN-79

Code
RIV-REN-79
Mercy ID
V-01217-01
Encounter Date
05/09/2003
Last
Rivera
First
Renata
DOB
11/11/1979
County
Dekalb
Street
3665 Chestnut Dr. Apt. F-4
City
Doraville
State
GA
Zip
30340-
Home
(770) 452-8558
Family Status
Single parent w/children
COB
Brazil
Gender
Female
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Rivera
First
Carlos
DOB
05/12/1975
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
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
No
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
Natalia Delima 01/09/1999 Grandmother Brazil
Phillip Rivera 04/26/2002 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
x3737 Damaryz