ACO-ADI-72

Code
ACO-ADI-72
Mercy ID
V-00463-01
Encounter Date
04/04/2001
Last
Acocal
First
Edith
DOB
01/14/1973
County
Gwinnett
Street
2000 Noble Forest Dr.
City
Norcross
State
GA
Zip
30092-
Cell
(678) 616-5179
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Cruz
First
Efren
DOB
06/17/1970
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Andrew Cruz 09/01/2007 Parents GA/USA
Coelsey Cruz 04/13/2002 Parents GA/USA
Jose Cisneros 10/23/1997 Mother w/Stepfather GA/USA
Mayra Cisneros 02/01/1995 Mother w/Stepfather GA/USA
Sergio Cisneros 09/28/1988 Adulto/Casado GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
S. Aviña
Referred By
linea-Juana