SUA-LOR-72

Code
SUA-LOR-72
Mercy ID
V-02123-01
Encounter Date
12/12/2005
Last
Suastegui
First
Lorena
DOB
05/14/1972
County
Gwinnett
Street
3888 Line Oak
City
Doraville
State
GA
Zip
30340-
Home
(770) 242-1835
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Other

Spouse Information

Last
Salgado
First
Imer
DOB
07/17/1973
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
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Helen Salgado 07/29/2005 Parents GA/USA
Imer Suastegui 02/25/1994 Parents GA/USA
Jason Salgado 04/25/1997 Parents GA/USA
Nelany Salgado 07/29/2000 Parents 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
R. Gonzalez
Referred By
Rafael Miranda