GOM-CEC-73

Code
GOM-CEC-73
Mercy ID
V-02974-01
Encounter Date
12/22/2008
Last
Gomez
First
Cecilia
DOB
11/22/1973
County
Gwinnett
Street
2854 Regent walk Drive
City
Duluth
State
GA
Zip
30096-
Home
(678) 475-1314
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Ramirez
First
Angel
DOB
10/01/1972
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
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Astrid Salazar 02/14/1995 Mother w/Stepfather GA/USA
Escarlett Alderete 11/04/2004 Parents GA/USA
Genesis Alderete 10/22/1996 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
linea-Juana