RIV-ERI-84

Code
RIV-ERI-84
Mercy ID
V-02128-01
Encounter Date
12/13/2005
Last
Rivas
First
Erica
DOB
07/24/1984
County
Gwinnett
Street
4294 Hoekins
City
Ln.
State
GA
Zip
30096-
Home
(678) 913-7936
Family Status
Adult coupie-no children
COB
El Salvador
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Mejia
First
Marcos
DOB
08/06/1975
Address
N/A
Telephone
N/A
COB
Ecuador
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
YES
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
G. Landeros
Data Entry
R. Gonzalez
Referred By
Fabiola Gomez