To submit an individual case report UPS Trackpad

Starting on December 1st please submit your individual case reports here- UPS Trackpad

Click here for the instructions Please report all cases unreported / reported/ with a Kit/ or without -

If you log in a case without a kit # you can put NA in the blank.

Feel free to contact me with any questions

The Vermont SANE Program has recently changed how we collect data on exams performed by SANEs in Vermont. Effective 12/1/18, all SANEs must complete an online form following each encounter with a sexual assault patient. This quick and easy form replaces the individual case and quarterly data collection that hospitals had previously been submitted on paper. Because of this change, the Vermont SANE program will also be able to provide statistics regarding the incidence of SANE exams statewide, and on the hospital and individual provider level.

To submit an individual case report, please click here.


This document provides basic instructions related to the administrative and billing process associated with the medical care of sexual assault victims. Basic protocols for hospital registration staff, sexual assault nurse examiners, billing departments and the Vermont Center for Crime Victim Services are outlined below.

Billing form  

PHI  Billing instructions



This document explains the procedure for screening a patient for possible drug facilitated sexual assault (DFSA) and the procedure for collecting and transporting urine samples for testing in suspected DFSA cases. Included are suggestions for patient education regarding the risks and benefits of testing, the procedure to request testing and the procedure for obtaining the test results. PDF

DFSA Screening and Testing Procedure


Patient Information

DFSA Survey