National Protocol For Sexual Assault Medical Forensic Examinations of Adults/Adolescents

The National Protocol for Sexual Assault Medical Forensic Examinations was designed as a guide for health care practitioners who respond to adolescent and adult victims of sexual assault. It is intended as a guideline for suggested practices, and can be a useful tool for those wishing to develop new protocols or to review or revise their existing protocols.

Since this protocol was initially released in 2004, the state of the art for forensic medical examinations has improved. This revised edition of the protocol has the same emphasis and values as the original, but has been updated to reflect current technology and practice. It has also been updated to include additional information reflecting changes from the Violence Against Women Act of 2005.  

The protocol offers recommendations to help standardize the quality of care for sexual assault victims around the country.

Throughout the protocol, the need for the use of coordinated multidisciplinary community responses to sexual violence is encouraged as the approach that will address both the needs of the victim and the justice system. The protocol is divided into 3 sections: overarching issues, operational issues and the examination process.


Many individuals contributed their skills and expertise to the development of this protocol. Special appreciation goes to Kristin Littel, who served as the primary writer and researcher for the protocol. We would also like to thank the Office for Victims of Crime for initiating this project and for providing feedback and guidance throughout the drafting process. We are grateful to all of the women and men who gave their time and energy to attend the focus groups, participate in the conference calls, and review numerous drafts of the protocol; their efforts greatly enhanced the final product. 

We are particularly grateful for the assistance of Gail Burns Smith who, in addition to participating in focus groups and conference calls and submitting insightful comments on drafts, also was responsible for suggesting and organizing conference calls with victims to ensure the victim-centeredness of the protocol.


Sexual violence continues to plague our Nation and destroy lives. All members of society are vulnerable to this crime, regardless of race, age, gender, ability, or social standing. When sexual assault does occur, victims deserve competent and compassionate care. This second edition of the National Protocol for Sexual Assault Medical Forensic Examinations provides detailed guidelines for criminal justice and health care practitioners in responding to the immediate needs of sexual assault victims. We know that effective collection of evidence is of paramount importance to successfully prosecuting sex offenders.

Just as critical is performing sexual assault forensic exams in a sensitive, dignified, and victim-centered manner. For individuals who experience this horrendous crime, having a positive experience with the criminal justice and health care systems can contribute greatly to their overall healing.

As we have learned in the years since the implementation of the 1994 Violence Against Women Act, coordinated community efforts are the best way to stop violence against women, hold offenders accountable for their crimes, and promote victim healing and recovery. That is why this protocol was designed as a guide for practitioners who respond to victims of sexual assault, including health care professionals, law enforcement officers, prosecutors, interpreters, advocates, and others. Combining cutting edge response techniques with collaboration among service providers will greatly enhance our ability to treat and support victims as well as identify and prosecute the sex offenders. We hope that this protocol lays the foundation for these efforts.  

International Association of Forensic Nurses

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This project was supported by Grant No.2011-TA-AX-K021 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this Web Site are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.