GAR-ERK-80

Code
GAR-ERK-80
Mercy ID
V-03530-01
Encounter Date
02/22/2011
Last
Garcia
First
Erika
DOB
10/27/1980
County
Gwinnett
Street
1346 Southern Woods Dr. Apt. B
City
Tucker
State
GA
Zip
30084-
Cell
(770) 875-6982
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
N/A
First
N/A
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
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
Erick Mendoza 01/16/2004 Mother GA/USA

Former Spouse 1 Information

Last
Contreras
First
Roberto
DOB
02/14/1975
Telephone
N/A
COB
Mexico
Home Owner
No
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