President's DNA Initiative Sexual Assault Medical Forensic Examinations
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The Examination Process > Exam and Evidence Collection Procedures

Exam and Evidence Collection Procedures

Recommendations at a glance for health care providers to facilitate the exam and evidence collection: 

  • Recognize the forensic purpose of the exam to document physical findings and facilitate the collection of evidence from patients.
  • Strive to collect as much evidence from patients as possible, guided by the scope of informed consent, the medical forensic history, examination findings, and evidence collection kit instructions. 
  • Be aware of evidence that may be pertinent to the issue of whether the patient consented to the sexual contact with the suspect. 
  • Understand how biological evidence is tested. 
  • Prevent exposure to infectious materials and contamination of evidence. 
  • Understand the implications of the presence or absence of seminal evidence. 
  • Modify the exam and evidence collection to address the specific needs and concerns of patients.
  • Explain exam and evidence collection procedures to patients.
  • Conduct the general physical and anogenital exam and document findings on body diagram forms. 
  • Collect evidence to submit to the crime lab for analysis, according to jurisdictional policy. Collect blood and/or urine for toxicology screening if applicable. 
  • Keep medical specimens separate from forensic specimens collected during the exam.



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  • This section: Exam and Evidence Collection Procedures (Adobe PDF)
  • Full document: A National Protocol for Sexual Assault Medical Forensic Examinations (Adobe PDF)
  • Goals of the Protocol
    • Roles of Responsders
  • Recommendations at a Glance
    • Goal of the Protocol
    • Overarching Issues
    • Operational Issues
    • The Examination Process
  • Overarching Issues
    • Coordinated Team Approach
      • Dual purpose of the exam
      • Key responders and their role
      • Quality assurance measures
    • Victim-Centered Care
      • Patient priorty as an emergency case
      • Patient privacy
      • Exam adapted to patients' needs and circumstances
      • Issues commonly faced by patients from specific populations
      • Importance of victim services within the exam process
      • Importance of personal support persons in the exam room
      • Requests for a responder of a specific gender
      • Explanation of procedures during the exam process
      • Integration of medical and forensic exam procedures
      • Patient safety during the exam process
      • Information patients can review at their conveniance
      • Physical comfort needs of patients
    • Informed Consent
      • Seeking informed consent as appropriate
      • Obtaining consent from specific populations
    • Confidentiality
      • Scope and limitations of confidentiality
      • Building understanding of confidentiality issues
      • Impact of Federal privacy laws
      • Difficulties in maintaining confidentiality
    • Reporting to Law Enforcement
      • Making the decision to report
      • Consequences of reporting
      • Alternatives to standard reporting procedures
      • Promoting a victim-centered process
    • Payment for the Examination under VAWA
  • Operational Issues
    • Sexual Assault Forensic Examiners
      • Specific knowledge, skills, and attitutes
      • Minimum standards for advanced educational and clinical requirements
    • Facilities
      • Obligation to serve patients
      • Use of specially educated and clinically prepared examiners
      • Optimal site locations
      • Basic requirements
      • Patient transfers
    • Equipment and Supplies
      • Availability of specfic equipment and supplies
      • Cost barriers
    • Sexual Assault Evidence Collection Kit
      • Minimum guidelines for contents
      • Standardized kits
    • Timing Considerations for Collecting Evidence
      • Importance of the history and exam findings
      • Prompt exam to minimize loss of evidence
      • Decisions made on a case-by-case basis
      • Resources for responders
    • Evidence Integrity
      • Policies to dry, package, label, and seal evidence
      • Evidence transfer policies
      • Storage policies
      • Documentation of evidence
  • The Examination Process
    • Initial Contact
      • Consensus among agencies regarding procedures
      • Essential activities
    • Triage and Intake
      • Priority cases
      • Acute care needs
      • Alerting examiners
      • Contacting advocates
      • Safety concerns upon arrival of patients at the site
      • Immediate medical and mental health interventions
    • Documentation by Health Care Personnel
      • Completion
      • Education for examiners
    • The Medical Forensic History
      • Coordination of history taking and investigative interviewing
      • Presence of advocates during the history
      • Patient needs addressed prior to and during history
      • Obtaining the history
    • Photography
      • Extent
      • Photographers and equipment
      • Patient comfort and privacy
      • Explanation of photography procedures
      • Taking photographs
    • Exam and Evidence Collection Procedures
      • Forensic purpose of the exam
      • Collecting as much evidence as possible
      • Issues related to consent to sexual contact
      • Testing of biological evidence
      • Exposure to infectious materials and evidence contamination
      • Importance of semen evidence
      • Addressing patient needs' and concerns
      • Explanation of exam and evidence collection procedures
      • Conducting the exam and documenting findings
      • Evidence to submit to the crime lab for analysis
      • Other evidence
      • Medical specimens separate from forensic specimins
    • Drug-Facilitated Sexual Assault
      • Training and development of policies
      • Response to voluntary use of drugs and/or alcohol
      • Circumstances in which testing may be indicated
      • Explanation of testing procedures
      • Collecting samples
      • Toxicology labs
      • Preservation of evidence and chain of custody
    • STI Evaluation and Care
      • Information on STIs
      • STI testing
      • Prophylaxis against STIs
      • Followup care
      • Concerns about HIV infection
    • Pregnancy Risk Evaluation and Care
    • Discharge and Followup
      • Medical discharge and followup care
      • Coordination among responders prior to discharge
    • Examiner Court Appearances
      • Broad education on court appearances
      • Prompt notification for examiners
      • Pretrial preparation
      • Feedback on testimony
  • Appendix A. Developing Customized Protocols: Considerations for Jurisdictions
  • Appendix B. Creation of Sexual Assault Response Teams
  • Bibliography
  • Sexual Assault Forensic Examiner Technical Assistance Web Site
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