LOP-ZEN-82

Code
LOP-ZEN-82
Mercy ID
V-01603-01
Encounter Date
05/18/2004
Last
Lopez
First
Zenayda
DOB
05/20/1982
County
Cobb
Street
408 Calibre Brook Way
City
Smyrna
State
GA
Zip
30080-
Home
(404) 452-6204
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Santana
First
Alejandro
DOB
12/05/1973
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
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Brison Amador Lopez 07/23/2000 Mother w/Stepfather GA/USA
Javier Alejander Lopez 04/23/1999 Mother w/Stepfather 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
Amiga/Damaryz