MEN-SEN-75

Code
MEN-SEN-75
Mercy ID
V-00298-01
Encounter Date
10/03/2000
Last
Mendez
First
Sandy
DOB
02/28/1975
County
Cobb
Street
210 Jonhston Pkwy NW
City
Kennessaw
State
GA
Zip
30152-
Home
(678) 581-1288
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Nuñez
First
Antonio jesus
DOB
07/07/1972
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
YES
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
Guadalupe Nuñez 04/08/2002 Grandfather GA/USA
Jessica Nuñez 03/02/2004 Grandfather GA/USA
Mirella Nely Sanchez 01/02/1993 Grandmother GA/USA
Sindy Nuñez 07/09/1999 Grandfather GA/USA
NOTES

Media Authoritation

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