BAE-HAY-63

Code
BAE-HAY-63
Mercy ID
V-01512-01
Encounter Date
03/03/2004
Last
Baez
First
Haydee
DOB
04/28/1966
County
Gwinnett
Street
510 Ambar Dr.
City
Norcross
State
GA
Zip
30071-
Home
(404) 604-4997
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Sanders
First
Jorge
DOB
11/18/1964
Address
N/A
Telephone
N/A
COB
Uruguay
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
Andres Sanders 08/18/1986 Mother GA/USA
Diego Sanders 10/18/1994 Mother GA/USA
Lorena Sanders 08/13/1990 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
Alicia Riveron/old clients