SUA-TER-71

Code
SUA-TER-71
Mercy ID
V-00200-01
Encounter Date
05/05/2000
Last
Suarez
First
Teresa
DOB
02/28/1971
County
Cobb
Street
5505 Moon Rd
City
Power springs
State
GA
Zip
30127-
Cell
(404) 396-5104
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Other

Spouse Information

Last
Suarez
First
Benjamin
DOB
04/01/1969
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
YES
Consentimiento De Participar
YES

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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Benjamin Suarez 05/26/2002 Parents GA/USA
Stephanie Suarez 04/11/1998 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
S. Aviña
Referred By