ARI-ELE-59

Code
ARI-ELE-59
Mercy ID
V-03130-01
Encounter Date
08/03/2009
Last
Arias
First
Eleina
DOB
01/31/1959
County
Fulton
Street
4912 Calibre Creek Parkway
City
Roswell
State
GA
Zip
30076-
Cell
(678) 396-0946
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Harris
First
Eduard
DOB
11/17/1947
Address
N/A
Telephone
N/A
COB
USA
Home Owner
YES
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
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
NOTES

Media Authoritation

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