GUZ-NAT-75

Code
GUZ-NAT-75
Mercy ID
V-01734-01
Encounter Date
10/13/2004
Last
Guzman
First
Natividad
DOB
12/14/1975
County
Cobb
Street
2640 Burrell Court
City
Kennesaw
State
GA
Zip
30144-
Home
(776) 562-4065
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Rivera
First
Roberto
DOB
11/11/1975
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
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
Erika 03/19/1994 DFACS GA/USA
Roberto 04/01/2003 DFACS GA/USA
Verenice 02/04/1996 DFACS GA/USA
Viridiana 06/08/1997 DFACS 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
DFACS/Walk in