VAS-WIL-79

Code
VAS-WIL-79
Mercy ID
V-02588-02
Encounter Date
08/25/2007
Last
Vasquez
First
William
DOB
12/24/1979
County
Gwinnett
Street
1180 Avalon Drive
City
Lawrenceville
State
GA
Zip
30044-
Cell
(404) 822-7905
Family Status
Two parent family w/children
COB
El Salvador
Gender
Male
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Espino
First
Adriana
DOB
01/27/1982
Address
N/A
Telephone
(770) 885-7556
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
David Vasquez 06/16/2003 Parents GA/USA
Lisette Vasquez 01/14/2005 Parents GA/USA
William Vasquez 03/21/2002 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
Felipe