CON-CIN-84

Code
CON-CIN-84
Mercy ID
V-03055-01
Encounter Date
04/22/2009
Last
Contreras
First
Cinthia
DOB
04/23/1984
County
Cobb
Street
1915 Cardell Road L-E 31
City
Austell
State
GA
Zip
30168-
Cell
(678) 949-0657
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Hernandez
First
Geovani
Middle
D.
DOB
12/16/1980
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
YES
Consentimiento De Participar
YES

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
Anthony Hernandez 06/02/2008 Parents GA/USA
Axel Hernandez 10/12/2001 Parents GA/USA
NOTES

Media Authoritation

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