ESC-ELU-74

Code
ESC-ELU-74
Mercy ID
V-02226-01
Encounter Date
04/06/2006
Last
Escalante
First
Elvia
DOB
06/30/1974
County
Dekalb
Street
not given
City
Chamblee
State
GA
Zip
30341-
Home
(770) 220-0731
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Vazquez
First
Urbano
DOB
05/25/1969
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
Ana Julia Escalante N/A N/A Guatemala
Avnert Vazquez 02/14/2004 Mother GA/USA
Evern Escalante N/A N/A Guatemala
Mariela Escalante N/A N/A Guatemala
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
Felipe Perez