RES-CLA-63

Code
RES-CLA-63
Mercy ID
V-03200-01
Encounter Date
11/02/2009
Last
Restrepo
First
Claudia
DOB
12/14/1963
County
Dekalb
Street
2578 Dresden Dr.
City
Chamblee
State
GA
Zip
30341-
Cell
(404) 475-8564
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Pavon
First
Ricardo
DOB
02/29/1964
Address
N/A
Telephone
N/A
COB
Ecuador
Home Owner
YES
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
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
Maria Jose Pavon 12/03/2002 Parents GA/USA
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