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INTIMATE PARTNER/SEXUAL VIOLENCE RESPONSE PROTOCOL
SAMPLE PROTOCOL FOR HOME VISITING AGENCIES
PURPOSE
MPH Family Home Visiting recommends universal screening for Intimate Partner Violence (IPA).
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How to fill out intimate partner violence protocol

How to fill out intimate partner violence protocol
01
Step 1: Begin by gathering all necessary information, such as the victim's name, contact details, and relationship to the perpetrator.
02
Step 2: Assess the victim's immediate safety and offer resources for shelter if necessary.
03
Step 3: Create a safe and confidential space for the victim to share their experiences and gather details about the incidents of violence.
04
Step 4: Document the victim's injuries or any evidence of abuse through photographs or written descriptions.
05
Step 5: Encourage the victim to seek medical attention if needed and provide them with information about local healthcare services.
06
Step 6: Contact law enforcement if the victim wishes to press charges or if there is an immediate threat to their safety.
07
Step 7: Offer emotional support and provide information about counseling or support groups for victims of intimate partner violence.
08
Step 8: Complete all required sections of the intimate partner violence protocol form, ensuring accuracy and thoroughness.
09
Step 9: Review the protocol with the victim, explaining its purpose, confidentiality, and how it will be utilized in their case.
10
Step 10: Store the completed protocol in a secure location and follow any applicable reporting procedures or guidelines.
Who needs intimate partner violence protocol?
01
Intimate partner violence protocol is needed by professionals working in healthcare, social services, law enforcement, and legal fields.
02
Victims of intimate partner violence also benefit from having access to the protocol, as it helps ensure their safety, document abuse, and assist in legal proceedings if necessary.
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What is intimate partner violence protocol?
Intimate partner violence protocol is a set of guidelines and procedures to address and respond to cases of violence between intimate partners.
Who is required to file intimate partner violence protocol?
Various professionals such as healthcare providers, social workers, law enforcement officers, and counselors may be required to file intimate partner violence protocol.
How to fill out intimate partner violence protocol?
To fill out intimate partner violence protocol, individuals need to provide detailed information about the incident, the parties involved, any injuries, and any actions taken.
What is the purpose of intimate partner violence protocol?
The purpose of intimate partner violence protocol is to ensure a standardized and effective response to cases of intimate partner violence, to protect victims, and hold perpetrators accountable.
What information must be reported on intimate partner violence protocol?
Information such as date of incident, location, names of individuals involved, description of incident, any injuries, and any previous incidents must be reported on intimate partner violence protocol.
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