FLO-TER-68

Code
FLO-TER-68
Mercy ID
V-01031-01
Encounter Date
11/12/2002
Last
Flores
First
Teresa
DOB
06/25/1968
County
Gwinnett
Street
855 Hill Crest Rd. NW
City
Lilburn
State
GA
Zip
30047-
Home
(404) 423-8276
Family Status
Two parent family w/children
COB
Nicaragua
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Leaburt
First
Alfredo
DOB
N/A
Address
N/A
Telephone
N/A
COB
Dominican Rep
Home Owner
YES
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
NOTES

Media Authoritation

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