Medical Forensic Exam

Before your exam:

• Place any items that may contain the perpetrator's DNA in a paper bag and bring them to the hospital with you. These may include your clothes, a condom or dental dam, a tampon, or bedsheets. 
• More evidence will remain intact if you are unshowered and do the exam as soon as possible after an assault. However, you can still receive an exam after using the restroom and showering, up to 7 (or 10) days afterward.
• If possible, collect your first urine sample to bring with you to the hospital.

When you arrive at the emergency room: 

• You will be asked to fill out registration paperwork. You will be screened by a few different personnel, including a doctor. They will ask you what happened to assess for  any immediate injuries (i.e. internal bleeding) that need attention. It can be difficult to recount the incident over and over again, but be sure to communicate any types of physical force that may have been used during the assault (including choking/strangulation). 
• Hospital staff will call a Forensic Nurse Examiner to come and perform the exam.
• The FNE will explain the various parts of the exam and that you have the right to provide, decline, or withdraw consent to any part of the exam at any time.
• Plan to spend 3-4 hours at the hospital. 
   

Many survivors choose to get a sexual assault exam as a step to ensure their physical health and wellbeing. While the exam offers each of the following parts, you can select to participate in all, some, or none of them:

• Oral account of the incident - This is documented by the nurse and kept as part of the exam kit. Any support people besides an advocate will likely be asked to step out during this time.
• Physical examination - The nurse will perform a head-to-toe physical examination and document any visible injuries on a body diagram and/or by taking photos. This may involve the use of a speculum for vaginal or anal exams. 
• Forensic evidence collection - The nurse may swab body parts where contact was made for potential DNA testing. They may also take toxicology samples via urine and/or blood, though substances often leave the system quickly. They will collect items that may have DNA from the perpetrator.
• Medication - Depending on the sexual contact that occurred, patients may choose emergency contraception and/or preventative medication for: gonorrheagonorrhae, chlamydia, bacterial vaginosis (BV), trichomonas, and HIV. The majority of these medications are covered by the exam (see cost section for more information). 
• STI Testing - No testing is done during the forensic exam for STIs, as they have an incubation period of 10-14 days. Patients will be provided information for follow-up resources regarding STI testing, injuries, and/or therapy if necessary.

It is important to note that a medical forensic exam cannot determine if a sexual assault occurred. However, if the assault is reported and the kit is tested, the results may confirm that sexual contact occurred and with whom. Medical forensic exams can be extremely helpful as evidence in a legal case if a survivor chooses to pursue one.
 

Medical forensic exams are free for all patients. If any additional medical care is needed, the patient/their insurance will be billed. An advocate can provide information on Minnesota Crime Victim Reimbursement, which compensates victims of crimes for medical costs if the crime was reported to law enforcement.

If a patient chooses to receive any preventative medication, most of these costs are covered by the county and not billed to the patient. There are two exceptions where the patient and/or their insurance would be billed:

• Medication for bacterial vaginosis - This cannot be taken at the hospital if the patient has consumed alcohol within the last 3 days. The nurse can send a prescription to a pharmacy. 
• Medication for chlamydia - This medication is taken over 7 days, and therefore, the nurse will send a prescription to a pharmacy. There are options for a one-time dose, which can be given at the hospital, that are less effective but are free to the patient.