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What is a Sexual Assault Forensic Examination?

Commonly referred to as “SAFE exams,” these are examinations in which standard medical services are provided and evidence related to a sexual assault is collected, catalogued, and preserved for scientific testing to link biological and non-biological material between two individuals. Some people also refer to SAFE exams as SANE exams, because many are conducted by Sexual Assault Nurse Examiners, who receive special training for collecting, preserving, and documenting physical evidence related to sexual assault.

Some Goals of SAFE Exams

  • Provide a safe environment for victims to process a sexual assault with nurses, advocates, and/or law enforcement.
  • Provide prompt, thorough medical assessment and intervention.
  • Provide prompt, meticulous collection, preservation, and documentation of evidence.
  • Assure appropriate collection and handling of evidence to the proper authorities for prosecution, if applicable.
  • Present expert legal documentation and testimony during legal proceedings.
  • Educate victims about their options and provide appropriate service referrals for a continuum of care.



Pros & Cons

  • Evidence will be collected that may help if you choose to file a police report
  • Physical injuries will be treated
  • Might help in identifying perpetrator
  • Can test for drugs & receive treatment for STI/STDs
  • Emergency contraceptive may be available
  • Crime Victims Comp possibly available if reported to law enforcement
  • Connects victim with advocacy agency for continuing emotional support

  • The exam does not necessarily prove that a sexual assault occurred
  • The exam is invasive and often physically uncomfortable
  • More people will know about the assault
  • Voluntary use of drugs or alcohol may show up in testing
  • Medical costs (aside from free SAFE exam)
How much does a SAFE exam cost the victim?

The exam consists of two parts: forensic and medical. The forensic exam is free to the victim; however, the victim may be billed for medical costs, which include, but are not limited to:

  • Testing for sexually transmitted diseases (STD) or human immunodeficiency virus (HIV) unless victim is under fourteen years of age.
  • Treatment/prevention of STD or HIV
  • Antibiotics
  • Pregnancy testing
  • Emergency contraception
  • Tetanus immunization
  • Wound care, laceration repair
  • Fractures/sprain treatment
  • Surgical procedures
  • Discharge instruction counseling
  • Outpatient follow-up
How can a CARDV advocate help?
  • Provide emotional support and emergency room advocacy
  • Provide referrals and resources
  • Clarify options and procedures of hospital and the exam
  • Provide transportation to and from University Hospital for the SAFE exam
  • Provide concrete resources when funding is available (For example, purchase emergency contraception from a pharmacy or help survivor find more affordable pricing for emergency contraception when funding is not available)
  • Follow-up services (safety planning, case management, counseling, CVC, etc.)
A few more things to keep in mind…
  • The ER is required to report gunshot victims to law enforcement and also child abuse to Children’s Division
  • SAFE exams are most successful if completed with 72 hours of the assault
  • Victims should try not to shower, change clothes, brush their teeth, or eat anything between the assault and the exam. If they have done one or some of these things and opt for a SAFE exam, send them directly to the hospital. So, for example, even if they ate dinner after being assaulted, they should not brush their teeth before going to the exam.
Crime Victims Compensation (CVC) for SAFE medical treatment

Crime Victims Compensation (CVC) may pay for “reasonable” expenses for medical treatment that directly resulted from the sexual assault. However, there are a few things to keep in mind such as (but not limited to):

  • CVC is the payer of last resort, so insurance can be billed first
  • Victims must report the sexual assault within 48 hours
    • Section 595.030.2, RSMo, requires a victim to report the crime to the proper law enforcement agency within 48 hours of the crime’s discovery. The Program may waive this requirement for good cause. Good cause would be if a victim was medically unable to make a claim within 48 hours. A victim filing a report after the time limit solely for compensation purposes rather than pursing criminal justice does not constitute good cause. A victim continually residing in a certified domestic violence shelter for up to five days from the date of the crime may constitute good cause for delay in reporting the crime.
  • Must cooperate with law enforcement and prosecution
  • Must not have been involved in any illegal activity at the time the crime occurred
  • At least $50 out-of-pocket expenses for medical, funeral, or counseling OR two continue weeks of lost wages

Missouri Crime Victims’ Compensation Program