CRU-VAL-78

Code
CRU-VAL-78
Mercy ID
V-03472-01
Encounter Date
11/10/2010
Last
Cruz
First
Valentina
DOB
10/05/1978
County
Dekalb
Street
2288 La vista Road Apt. 1
City
Atlanta
State
GA
Zip
30329-
Cell
(404) 707-7179
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Hernandez
First
Marbel
DOB
05/06/1981
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
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
Emilio Hernandez Cruz 06/22/2007 Parents GA/USA
Fernando Cruz Hernandez 09/17/1999 Parents GA/USA
Valeria Hernandez Cruz 10/31/2005 Parents GA/USA
NOTES
Hermana de Luz Mayra Cruz

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
C. Martinez
Data Entry
J. Manzo
Referred By
Walk in