<p class="cf-meta-value"><strong>Name</strong><br>Eileen Y Hernandez</p><p class="cf-meta-value"><strong>Email Address</strong><br>eileenandfamily4@gmail.com</p><p class="cf-meta-value"><strong>Telephone</strong><br>860-884-4401</p><p class="cf-meta-value"><strong>Street address</strong><br>11 pulaski st </p><p class="cf-meta-value"><strong>City</strong><br>Jewett city </p><p class="cf-meta-value"><strong>State</strong><br>Ct</p><p class="cf-meta-value"><strong>Zip</strong><br>06360</p><p class="cf-meta-value"><strong>Date of Birth</strong><br>03/05/1977</p><p class="cf-meta-value"><strong>Appointment Reminders</strong><br>Text</p><p class="cf-meta-value"><strong>Ages of Children Involved in Court Case</strong><br>7 and 9 </p><p class="cf-meta-value"><strong>Name of Court</strong><br>Norwich JD</p><p class="cf-meta-value"><strong>Other Parent Name</strong><br>Jorge Hernandez </p><p class="cf-meta-value"><strong>Do you wish to participate in the program with the other parent?</strong><br>No</p><p class="cf-meta-value"><strong>Is there any history of violence or abuse within the family?</strong><br>Yes</p><p class="cf-meta-value"><strong>Does the participant speak English?</strong><br>Yes</p><p class="cf-meta-value"><strong>Is the participant hearing impaired?</strong><br>No</p><p class="cf-meta-value"><strong>Emergency Contact Name</strong><br>Mary cepeda </p><p class="cf-meta-value"><strong>Emergency Contact Telephone</strong><br>856-777-3888</p>