ARE-ROS-75

Code
ARE-ROS-75
Mercy ID
V-02568-01
Encounter Date
03/03/2008
Last
Arevalo
First
Rosa
DOB
09/25/1975
County
Gwinnett
Street
3111 Winn Drive
City
Lawrenceville
State
GA
Zip
30044-
Cell
(770) 895-1041
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
Isabel Flores 02/10/1999 Mother GA/USA
Joel Arevalo 04/30/2002 Mother GA/USA
Joselin Arevalo 08/15/2004 Mother GA/USA

Former Spouse 1 Information

Last
Flores
First
Jose
DOB
04/29/1967
Telephone
N/A
COB
El Salvador
Home Owner
YES
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana