NEG-AME-71

Code
NEG-AME-71
Mercy ID
V-02010-01
Encounter Date
06/15/2005
Last
Negron
First
Amelia
DOB
05/07/1971
County
Clayton
Street
10612 Cherry Clove
City
Jonesboro
State
GA
Zip
30238-
Home
(678) 851-6530
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Negron
First
Ramon
DOB
N/A
Address
N/A
Telephone
N/A
COB
Puerto Rico
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
Josue Negron 11/13/1990 Father w/Stepmother GA/USA
Lesly Negron 06/17/1995 Mother w/Stepfather GA/USA
Lisbeth Lopez 09/18/1991 Mother w/Stepfather GA/USA
Natalie Negron 06/26/2001 Father w/Stepmother GA/USA
Ramon Negron 02/18/1987 Father w/Stepmother GA/USA
Rosa Negron 06/28/1989 Father w/Stepmother 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