CON-REN-74

Code
CON-REN-74
Mercy ID
V-02299-02
Encounter Date
07/17/2006
Last
Salinas
First
Rene
DOB
10/12/1974
County
Rockdale
Street
1757 Hunting Creek Dr.
City
Coneyrs
State
GA
Zip
30013-
Home
(770) 192-9323
Cell
(678) 733-6606
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Lozano
First
Martha
DOB
10/16/1978
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
YES
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
YES
Rockdale
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
Erick Contreras 02/17/2001 Parents GA/USA
Fatima Contreras 05/18/1995 Parents GA/USA
Guadalupe Contrera 09/23/1993 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
J. Manzo
Referred By
Dr. Robert Cook