Code
LOP-YEN-73
Mercy ID
V-03532-01
Encounter Date
03/01/2011
Last
Lopez
First
Yenny
DOB
03/10/1973
County
Dekalb
Street
426 Lincoln Court Ave.
City
Atlanta
State
GA
Zip
30329-
Cell
(781) 354-2992
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
College Degree

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
YES
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
No
Driver License Date
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
Bryant Diaz 08/05/1995 Mother Colombia
Stephanie Diaz 07/13/2006 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
Linea-Jacqueline