HER-LEO-67

Code
HER-LEO-67
Mercy ID
V-02855-01
Encounter Date
07/16/2008
Last
Heredia
First
Leonor
DOB
05/10/1967
County
Gwinnett
Street
1306 Sugar Wood Lane
City
Norcross
State
GA
Zip
30093-
Home
(770) 381-7851
Cell
(770) 256-2218
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Vocational/Technical

Spouse Information

Last
Aviles
First
Luis
DOB
04/04/1965
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
YES
As A Child
YES
Relative
YES
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Edwin Aviles 11/03/2000 Parents GA/USA
Lizette Aviles 03/23/1993 Parents GA/USA
Luis E. Aviles 06/25/1999 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
Wendy