JUA-ANA-76

Code
JUA-ANA-76
Mercy ID
V-01861-01
Encounter Date
11/12/2005
Last
Juarez
First
Anaida
DOB
04/08/1976
County
Dekalb
Street
2010 Curtix Dr. K2
City
Atlanta
State
GA
Zip
30319-
Home
(404) 633-1199
Cell
(404) 542-8405
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Garcia
First
Juan carlos
DOB
N/A
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
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
Carla Garcia 03/30/2002 Parents GA/USA
Carlos Garcia 09/20/2005 Parents GA/USA
Jacqueline Juarez 04/25/1998 Parents GA/USA
Lesly Garcia 06/23/2004 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By