BAR-CAR-87

Code
BAR-CAR-87
Mercy ID
V-02211-01
Encounter Date
03/27/2006
Last
Varela
First
Carmen
DOB
07/16/1978
County
Dekalb
Street
2235 Place Rd.
City
Chamblee
State
GA
Zip
30345-
Home
(678) 789-3870
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Preschool

Spouse Information

Last
Gutierrez
First
Erasmo
DOB
11/29/1977
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
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
Jorge Luis Gutierrez 04/04/2006 Parents GA/USA
Maximiliano Gutierrez 11/29/1999 Aunt Mexico
Patricia Gutierrez 05/19/1998 Aunt Mexico
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