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STEP 3Assault HistoryAssault DateTimeExam DateTimeHospitalCityPage 1Place Patient Label HereAssailant Information Name(s)Relationship to PatientAgeInjured or bleeding? Which of the following occurred?
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How to fill out drug facilitated sexual assault

01
Start by providing all the necessary personal information, such as your name, age, and contact details.
02
Next, describe the details of the incident, including the date, time, and location of the assault.
03
Specify the type of drugs or substances that were allegedly used to facilitate the assault.
04
Provide a detailed account of the sequence of events leading up to and following the assault.
05
Include any relevant information about the perpetrator, such as their name, physical appearance, or any identifying details.
06
Attach any supporting evidence you may have, such as medical reports, photographs, or witness statements.
07
Sign and date the form to acknowledge the accuracy and completeness of the provided information.
08
Submit the filled-out form to the appropriate law enforcement or legal authorities for further investigation.

Who needs drug facilitated sexual assault?

01
Drug facilitated sexual assault is a serious issue affecting individuals who have been subjected to sexual assault or abuse in which drugs or substances were used to facilitate or incapacitate them.
02
Anyone who has experienced a suspected or confirmed drug facilitated sexual assault can report it and fill out the necessary forms to seek justice and support.
03
It is important to remember that no one deserves or asks for such violence, and it is crucial to support and believe survivors of these crimes.
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Drug facilitated sexual assault involves the use of drugs to incapacitate a person in order to commit sexual assault.
Any victim of drug facilitated sexual assault or anyone who has knowledge of such an incident should report it to the appropriate authorities.
To report drug facilitated sexual assault, one should gather as much information as possible about the incident and contact law enforcement or a sexual assault hotline for guidance on how to proceed with filing a report.
The purpose of drug facilitated sexual assault is to incapacitate a victim in order to commit sexual assault without their consent.
Information such as the date and location of the incident, description of the perpetrator(s), any evidence of drugs being used, and the victim's account of the assault should be reported.
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