COO-AMA-65

Code
COO-AMA-65
Mercy ID
V-02823-01
Encounter Date
06/24/2008
Last
Cook
First
Amanda
DOB
10/11/1965
County
Dekalb
Street
2935 N. Dekalb Dr. #208
City
Atlanta
State
GA
Zip
30340-
Cell
(404) 781-3664
Family Status
Two parent family w/children
COB
USA
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Sanchez
First
Fernando
DOB
08/10/1980
Address
N/A
Telephone
N/A
COB
Guatemala
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
Elizabeth Cook 10/07/2002 Parents GA/USA
Keylan Cook 07/13/1995 Mother w/Stepfather GA/USA
Sergio Cook 01/28/2000 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
J. Manzo
Referred By
Jacqueline