GAI-KAT-78

Code
GAI-KAT-78
Mercy ID
V-00766-01
Encounter Date
12/04/2001
Last
Gaitan
First
Katherine
DOB
09/30/1978
County
Fulton
Street
6942 Spring Wood Dr.
City
Douglasville
State
GA
Zip
30328-
Home
(678) 838-9541
Family Status
Two parent family w/children
COB
USA
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Quiñones
First
Jhony
DOB
10/11/1973
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
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
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
Evaluación