SANE CASE DOCUMENT LOG

To submit an individual case report, please click here.

The Vermont SANE Program has recently changed how we collect data on exams performed by SANEs in Vermont. Effective 7/1/16, 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.

SEXUAL ASSAULT BILLING FORMS

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

 

DRUG FACILITATED SEXUAL ASSAULT 

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.

DFSA Screening and Testing Procedure

 Consent 

Patient Information

DFSA Survey