ROD-KAR-75

Code
ROD-KAR-75
Mercy ID
V-03238-01
Encounter Date
01/13/2010
Last
Rodriguez
First
Karla
DOB
11/07/1975
County
Cobb
Street
273 Hood Pkwy
City
Kennesaw
State
GA
Zip
30152-
Cell
(404) 391-0692
Other
(404) 534-7637
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
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
Brandon Mendez 11/22/1997 Mother GA/USA
Brittany K. Valdez 11/23/2001 Mother GA/USA
Camila P. Rodriguez 01/20/2008 Mother GA/USA
Daniel J. Valdez 04/21/2004 Mother GA/USA

Former Spouse 1 Information

Last
Martinez
First
Baldo
DOB
05/26/1986
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

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