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Part B Kit Drug Facilitated Sexual Assault Patient Consent Form for Evidence Collection and Release or Storage AFFIX PATIENT LABEL Or Enter Patient Name: ___Additional Information Patient Phone:Patient

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How to fill out drug facilitated sexual assault

01

Seek medical attention as soon as possible.

02

Preserve any evidence by not showering or changing clothes.

03

Report the incident to the authorities.

04

Seek support from a counselor or therapist.

Who needs drug facilitated sexual assault?

01

Anyone who has been a victim of drug facilitated sexual assault.

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What is drug facilitated sexual assault?

Drug facilitated sexual assault involves the use of drugs or alcohol to incapacitate a person in order to commit a sexual assault.

Who is required to file drug facilitated sexual assault?

The victim of drug facilitated sexual assault or a witness to the assault may be required to file a report.

How to fill out drug facilitated sexual assault?

To file a report on drug facilitated sexual assault, the victim or witness should contact law enforcement or a sexual assault hotline.

What is the purpose of drug facilitated sexual assault?

The purpose of drug facilitated sexual assault is to commit a sexual assault while the victim is incapacitated by drugs or alcohol.

What information must be reported on drug facilitated sexual assault?

Information such as the details of the assault, any known drug or alcohol used, and the identity of the perpetrator should be reported.

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