GON-MAR-69

Code
GON-MAR-69
Mercy ID
V-02284-01
Encounter Date
07/05/2006
Last
Gonzalez
First
Maria magdalena
DOB
07/23/1969
County
Gwinnett
Street
3350 Sweetwater Rd.
City
Lawrenceville
State
GA
Zip
30029-
Home
(770) 935-9566
Cell
(404) 626-6961
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Velazquez
First
Felipe
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
YES
Consentimiento De Participar
YES

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
Isabel Velazquez 06/05/1998 Mother GA/USA
Jenifer Velazquez 05/24/1992 Mother GA/USA
Luis Velazquez 07/08/1993 Mother 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
J. Manzo
Referred By
walk-in