An Internet Resource for Forensic Investigation
of Child Sexual Abuse Cases

Medical Evaluations of Suspected Child Victims

Randell Alexander, Ph.D., M.D.

The most thorough model of health service delivery to an allegedly abused child is a comprehensive examination by a physician with specialized training in diagnosing and treating medical child abuse issues. Such specialized physicians, unfortunately, do not exist in large numbers in every community, and are not equally distributed geographically throughout the state.

Physicians who may serve in the role of Expert Witness regarding the medical examination of a child for whom physical or sexual abuse has been alleged must have additional specialized training for that purpose. A few physicians in Georgia have such specialized training and are functioning independently in clinics, hospitals, and practices scattered throughout the state. One possible approach to addressing the systemic shortage of appropriate service delivery to abused children is to develop a network of expert physician specialists throughout the state.

Such is the purpose of a newly developing project entitled Georgia Child Abuse Resource and Evaluation System (GA CARES). These experts will have ready access to each other's expertise, and each can continually refine an approach to the medical examination of suspected victims that can become increasingly standardized and effective. Such goals are the intention of GA CARES, which will eventually link centers of medical expertise throughout the state through the use of telemedicine.

Health service providers throughout the state will become more and more familiar with this linked medical service delivery model, and a center will eventually be within about an hour's drive from anywhere in the state. When a health service provider receives a referral of a suspected child abuse victim, he or she can make use of this referral system and directly encourage the use of the service. The nearest center can then be contacted and they can recommend how soon the examination should take place. Please be aware that for acute medical conditions, ideal timing requires an examination within 24 hours of an alleged child abuse incident. The healing process of genital tissue in children can be very rapid; waiting several days for an examination may result in a loss of findings.

However, many abuse allegations are about incidents that happened weeks or even months beforehand. In these cases, speed of examination is not such an issue since acute findings will have already changed or disappeared. Calling the nearest GA CARES center will be the best way to get advice on what needs to be done in terms of the timing of the exam.

Frequently, family members will bring the child to a primary care physician without calling ahead to indicate the suspected issue. In these cases, doctors often find themselves in the process of gathering information with the child in the office before realizing that it is a suspected abuse case. In other cases, the family may bring the child in and represent the issue as an "injury" or "accident" which the doctor questions based on exam or lab results. In these cases, the physician needs to ask the child why he or she is there, being sure to record the exact words the child discloses when abuse is either alleged or suspected. Doctors without specialized training should not attempt to complete a thorough forensic interview, however, and need to leave this to the proper professionals who have this training and role. However, if the child discloses abuse spontaneously to any physician, that allows for the physician to testify to the hearsay comments of the child in court. Thus, the exact wording of the child's statements is very important, and may also represent an "initial outcry" which has even greater forensic significance.

An additional advantage to an examination by a specialist physician also relates to that professional's training as a physician. The primary purpose of intervention by any physician should always be the well being of the patient. Evidence collection in potential child abuse situations actually represents a secondary purpose. Therefore, if a child has other medical problems that are NOT the result of child abuse, the physician will also be involved in the pursuit of a treatment plan to address those other medical needs.

The exact steps taken in the medical examination of a suspected abuse victim in a GA CARES center will probably continue to evolve through the shared experiences of experts and their suggested refinements. However, the initial areas to review are outlined in this standardized approach documentation:

PHYSICAL ABUSE/NEGLECT EVALUATION

GA CARES
(GA CHILD ABUSE RESOURCE AND EVALUATION SYSTEM)

Intake

  1. Date of evaluation ______________
  2. Time of evaluation ______________
  3. Location: FGE Clinic _______ Inpatient ______ ER ________
    Other ________

Patient Demographics

  1. Patient name _________________________________
  2. Birthdate ____________________________________
  3. Hospital ID # _________________________________
  4. Gender: Female ________ Male _________
  5. Race: White _____ African-American _____ Hispanic _____
    Asian _____ Other ______
  6. Insurance: Private ____ Medicaid ____ Peachcare _____ Other_____

Family Dynamics

Person accompanying child:

  1. Name ________________________________________
  2. Relationship to patient ____________________________
  3. Who lives in the household? ______________________________

Mother

  1. Name: __________________________________
  2. Age: _____________________
  3. Marital status: Married _____ Single ______ Divorced (why?) _______
  4. Employer ________________________________________
  5. Education level ____________________________________
  6. Development ______________________________________
  7. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  8. Psych problems ____________________________________
    ________________________________________________
    ________________________________________________
  9. Legal problems ____________________________________
    ________________________________________________
    ________________________________________________
  10. Alcohol problems __________________________________
  11. Drug problems ____________________________________
    ________________________________________________
  12. Childhood mistreatment? _____________________________

Father

  1. Name: _________________________
  2. Age: _____________________
  3. Marital status: Married _____ Single ______ Divorced (why?) _______
  4. Employer _______________________________________
  5. Education level ___________________________________
  6. Development ____________________________________
  7. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  8. Psych problems ___________________________________
    ________________________________________________
    ________________________________________________
  9. Legal problems ____________________________________
    ________________________________________________
    ________________________________________________
  10. Alcohol problems __________________________________
  11. Drug problems ____________________________________
    ________________________________________________
  12. Childhood mistreatment? _____________________________

PHYSICAL ABUSE/NEGLECT EVALUATION

GA CARES
(GA CHILD ABUSE RESOURCE AND EVALUATION SYSTEM)

Alleged perpetrator

  1. Name: __________________________
  2. Age: _____________________
  3. Marital status: Married _____ Single ______ Divorced (why?) _______
  4. Employer ________________________________________
  5. Education level ____________________________________
  6. Development ______________________________________
  7. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  8. Psych problems ____________________________________
    ________________________________________________
    ________________________________________________
  9. Legal problems ____________________________________
    ________________________________________________
    ________________________________________________
  10. Alcohol problems __________________________________
  11. Drug problems ____________________________________
    ________________________________________________
  12. Childhood mistreatment? _____________________________

PHYSICAL ABUSE/NEGLECT EVALUATION

GA CARES
(GA CHILD ABUSE RESOURCE AND EVALUATION SYSTEM)

Siblings
#1

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to patient: Same parents ____ Same mother only ____
    Same father only ____ Other _____
  4. Education level ____________________________________
  5. Development ______________________________________
  6. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  7. Psych problems ____________________________________
    ________________________________________________

#2

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to patient: Same parents ____ Same mother only ____
    Same father only ____ Other _____
  4. Education level ____________________________________
  5. Development ______________________________________
  6. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  7. Psych problems ____________________________________
    ________________________________________________

#3

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to patient: Same parents ____ Same mother only ____
    Same father only ____ Other _____
  4. Education level ____________________________________
  5. Development ______________________________________
  6. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  7. Psych problems ____________________________________
    ________________________________________________

#4

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to patient: Same parents ____ Same mother only ____
    Same father only ____ Other _____
  4. Education level ____________________________________
  5. Development ______________________________________
  6. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  7. Psych problems ____________________________________
    ________________________________________________

CHIEF COMPLAINT AND HISTORY

  1. Chief complaint:
    ___________________________________________________________
    ___________________________________________________________
    ___________________________________________________________
    ___________________________________________________________
    ___________
  2. CC provided by: Patient _____ Mother _____ Father _____
    DFCS _____ Police ______ Relative ________
    Other (specify) __________________

History

According to _______________________:

Review of Systems:
79. Constitutional Normal?_______Abnormal?_______
80. Head/scalp Normal?_______Abnormal?_______
81. Eyes Normal?_______Abnormal?_______
82. Ears Normal?_______Abnormal?_______
83. Nose Normal?_______Abnormal?_______
84. Mouth Normal?_______Abnormal?_______
85. Throat Normal?_______Abnormal?_______
86. Neck Normal?_______Abnormal?_______
   
87. Cardiovascular Normal?_______Abnormal?_______
88. Respiratory Normal?_______Abnormal?_______
89. GI Normal?_______Abnormal?_______
90. GU Normal?_______Abnormal?_______
91. Skin Normal?_______Abnormal?_______
92. Neuromuscular Normal?_______Abnormal?_______
93. Psych Normal?_______Abnormal?_______

If abnormal, explain:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_________________________

Past History:

  1. Diet _______________________________________________
  2. Medications _________________________________________
  3. Allergies ____________________________________________
  4. Immunizations ________________________________________
  5. Significant illnesses _____________________________________
  6. Hospitalizations _______________________________________
    ____________________________________________________
    ____________________________________________________
    ____________________________________________________
    ____________________________________________________
  7. Surgeries ____________________________________________

Comments:

Family and Social History:

Is there a further family history of:

101. Alcohol problems? No_______Yes(describe who)_______
102. Allergies? No_______Yes(describe who)_______
103. Bone problems? No_______Yes(describe who)_______
104. Cancer? No_______Yes(describe who)_______
105. Diabetes? No_______Yes(describe who)_______
106. DFCS problems? No_______Yes(describe who)_______
107. Drug problems? No_______Yes(describe who)_______
108. Easy bruising? No_______Yes(describe who)_______
109. Heart problems? No_______Yes(describe who)_______
110. High blood pressure? No_______Yes(describe who)_______
111. Legal/jail problems? No_______Yes(describe who)_______
112. Seizures? No_______Yes(describe who)_______
113. Physical mistreatment? No_______Yes(describe who)_______
114. Sexual mistreatment? No_______Yes(describe who)_______
115. Domestic violence? No_______Yes(describe who)_______
  1. How were you (the person(s) giving the history) treated as a child?




  2. Do you, the caregiver (male___ female___) perceive yourself to be in personal danger? No___ Yes (describe by whom) _____________



  3. Other comments

PHYSICAL EXAMINATION

Growth:

Height
119._____(cm,in) 120. %ile for age_____ 121. %ile for height_____

Weight
122._____(cm,in) 123. %ile for age_____ 124. %ile for height_____

Head circumference
125._____(cm,in) 126. %ile for age_____ 127. %ile for height_____

Body mass index (BMI)
128.__________

Examination

129. General appearance:________________________________
130. Head Normal_________Abnormal___________
131. Eyes Normal_________Abnormal___________
132. Ears Normal_________Abnormal___________
133. Nose Normal_________Abnormal___________
134. Mouth Normal_________Abnormal___________
135. Throat Normal_________Abnormal___________
136. Neck Normal_________Abnormal___________
137. Respiratory Normal_________Abnormal___________
138. Cardio-vase Normal_________Abnormal___________
139. Abdomen Normal_________Abnormal___________
140. GU Normal_________Abnormal___________
141. Extremeties Normal_________Abnormal___________
142. Neuro/develop Normal_________Abnormal___________
143. Skin Normal_________Abnormal___________

Describe any significant findings:

DATA

Lab

144. CBC: Normal_________Abnormal___________Value_________
145. Hgb Normal_________Abnormal___________Value_________
146. WBC Normal_________Abnormal___________Value_________
147. Platelets Normal_________Abnormal___________Value_________
148. Liver enzymes Normal_________Abnormal___________Value(s)_________
149. Amylase Normal_________Abnormal___________Value_________
150. Lipase Normal_________Abnormal___________Value_________
151. U/A Normal_________Abnormal(specify)___________
152. Other__________________________

Radiology

    Skeletal survey:
    1. (date/time ________________)
        2. Normal______Abnormal(specify)____________
        ______________________________________
        ______________________________________
        ______________________________________
        ______________________________________
    Bone scan:
    1. (date/time ________________)
        2. Normal______Abnormal(specify)____________
        ______________________________________
        ______________________________________
        ______________________________________
        ______________________________________
    CT of the:
    1. Head(date/time ________________)
        2. Normal______Abnormal(specify)____________
        ______________________________________
        ______________________________________
        ______________________________________
        ______________________________________
    Abdomen:
    1. (date/time ________________)
        2. Normal______Abnormal(specify)____________
        ______________________________________
        ______________________________________
        ______________________________________
        ______________________________________
    Other:
    1. (date/time ________________)
        2. Normal______Abnormal(specify)____________
        ______________________________________
        ______________________________________
        ______________________________________
        ______________________________________
    MRI of the:
    1. (date/time ________________)
        2. Normal______Abnormal(specify)____________
        ______________________________________
        ______________________________________
        ______________________________________
        ______________________________________
    1. (date/time ________________)
        2. Normal______Abnormal(specify)____________
        ______________________________________
        ______________________________________
        ______________________________________
        ______________________________________
    Photographs
    1. Taken? Yes___No___
    2. Who has photographs? Polic____DFCS____Hospital/Center____
Consults?(check of applies)
162. Forensice genital evaluation Obtained______Recommended______
163 Denistry Obtained______Recommended______
164. Dermatology Obtained______Recommended______
165. Neurology Obtained______Recommended______
166. Neurosurgery Obtained______Recommended______
167. Opthamology Obtained______Recommended______
168. Orthopedics Obtained______Recommended______
169. Pediatric surger Obtained______Recommended______
170. Other (specify) _________ Obtained______Recommended______

Comments:

IMPRESSIONS/RECOMENDATIONS

Impressions (list acute, chronic, developmental, family/social problems):



Recommendations:



Reporting (date/time/name of investigator):

  1. DFCS________________________
  2. Police________________________

Other comments:



FORENSIC GENITAL EVALUATION

GA CARES
(GA CHILD ABUSE RESOURCE AND EVALUATION SYSTEM)

Intake

  1. Date of evaluation ______________
  2. Time of evaluation ______________
  3. Location: FGE Clinic _______ Inpatient ______ ER ________
    Other ________

Patient Demographics

  1. Patient name _________________________________
  2. Birthdate ____________________________________
  3. Hospital ID # _________________________________
  4. Gender: Female ________ Male _________
  5. Race: White _____ African-American _____ Hispanic _____
    Asian _____ Other ______
  6. Insurance: Private ____ Medicaid ____ Peachcare _____ Other_____

Family Dynamics

Person accompanying child:

  1. Name ________________________________________
  2. Relationship to patient ____________________________
  3. Who lives in the household? ______________________________

Mother

  1. Name: __________________________________
  2. Age: _____________________
  3. Marital status: Married _____ Single ______ Divorced (why?) _______
  4. Employer ________________________________________
  5. Education level ____________________________________
  6. Development ______________________________________
  7. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  8. Any STDs?_______________________________________
  9. Psych problems ____________________________________
    ________________________________________________
    ________________________________________________
  10. Legal problems ____________________________________
    ________________________________________________
    ________________________________________________
  11. Alcohol problems __________________________________
  12. Drug problems ____________________________________
    ________________________________________________
  13. Childhood mistreatment? _____________________________

Father

  1. Name: _________________________
  2. Age: _____________________
  3. Marital status: Married _____ Single ______ Divorced (why?) _______
  4. Employer _______________________________________
  5. Education level ___________________________________
  6. Development ____________________________________
  7. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  8. Any STDs?_______________________________________
  9. Psych problems ___________________________________
    ________________________________________________
    ________________________________________________
  10. Legal problems ____________________________________
    ________________________________________________
    ________________________________________________
  11. Alcohol problems __________________________________
  12. Drug problems ____________________________________
    ________________________________________________
  13. Childhood mistreatment? _____________________________

PHYSICAL ABUSE/NEGLECT EVALUATION

GA CARES
(GA CHILD ABUSE RESOURCE AND EVALUATION SYSTEM)

Alleged perpetrator

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to victim:__________________________
  4. Marital status: Married _____ Single ______ Divorced (why?) _______
  5. Employer ________________________________________
  6. Education level ____________________________________
  7. Development ______________________________________
  8. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  9. Any STDs?_____________________________________
  10. Psych problems ____________________________________
    ________________________________________________
    ________________________________________________
  11. Legal problems ____________________________________
    ________________________________________________
    ________________________________________________
  12. Alcohol problems __________________________________
  13. Drug problems ____________________________________
    ________________________________________________
  14. Childhood mistreatment? _____________________________

PHYSICAL ABUSE/NEGLECT EVALUATION

GA CARES
(GA CHILD ABUSE RESOURCE AND EVALUATION SYSTEM)

Siblings
#1

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to patient: Same parents ____ Same mother only ____
    Same father only ____ Other _____
  4. Education level ____________________________________
  5. Development ______________________________________
  6. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  7. Psych problems ____________________________________
    ________________________________________________

#2

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to patient: Same parents ____ Same mother only ____
    Same father only ____ Other _____
  4. Education level ____________________________________
  5. Development ______________________________________
  6. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  7. Psych problems ____________________________________
    ________________________________________________

#3

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to patient: Same parents ____ Same mother only ____
    Same father only ____ Other _____
  4. Education level ____________________________________
  5. Development ______________________________________
  6. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  7. Psych problems ____________________________________
    ________________________________________________

#4

  1. Name: __________________________
  2. Age: _____________________
  3. Relationship to patient: Same parents ____ Same mother only ____
    Same father only ____ Other _____
  4. Education level ____________________________________
  5. Development ______________________________________
  6. Medical problems __________________________________
    ________________________________________________
    ________________________________________________
  7. Psych problems ____________________________________
    ________________________________________________

CHIEF COMPLAINT AND HISTORY

  1. Chief complaint:
    ___________________________________________________________
    ___________________________________________________________
    ___________________________________________________________
    ___________________________________________________________
    ___________
  2. CC provided by: Patient _____ Mother _____ Father _____
    DFCS _____ Police ______ Relative ________
    Other (specify) __________________

History

According to _______________________:

Acts ascribed to victim:

    Yes No Unk
83. Vaginal contact ___ ___ ___
  84. Penis ___ ___ ___
  85. Finger ___ ___ ___
  86. Object ___ ___ ___
    Yes No Unk
87. Anal contact ___ ___ ___
  88. Penis ___ ___ ___
  89. Finger ___ ___ ___
  90. Object ___ ___ ___
    Yes No Unk
91. Oral contact ___ ___ ___
  92. Genital ___ ___ ___
  93. Anal ___ ___ ___

Acts described committed by victim:

    Yes No Unk
94.Genital contact ___ ___ ___
95.Anal contact ___ ___ ___
96.Oral contact ___ ___ ___

Other Acts

    Yes No Unk
97. Threat of force/harm? ___ ___ ___
98. Videos/pictures taken/shown? ___ ___ ___
99. Last act within 72 hours? ___ ___ ___

 

Review of Systems:
100. Constitutional Normal?_______Abnormal?_______
101. Head/scalp Normal?_______Abnormal?_______
102.. Eyes Normal?_______Abnormal?_______
103.. Ears Normal?_______Abnormal?_______
104. Nose Normal?_______Abnormal?_______
105. Mouth Normal?_______Abnormal?_______
106. Throat Normal?_______Abnormal?_______
107. Neck Normal?_______Abnormal?_______
108. Cardiovascular Normal?_______Abnormal?_______
109. Respiratory Normal?_______Abnormal?_______
110. GI Normal?_______Abnormal?_______
111. GU Normal?_______Abnormal?_______
112. Skin Normal?_______Abnormal?_______
113. Neuromuscular Normal?_______Abnormal?_______
114. Psych Normal?_______Abnormal?_______

If abnormal, explain:

 

Past History:
  1. Diet _______________________________________________
  2. Medications _________________________________________
  3. Allergies ____________________________________________
  4. Immunizations ________________________________________
  5. Significant illnesses _____________________________________
  6. Hospitalizations _______________________________________
    ____________________________________________________
    ____________________________________________________
    ____________________________________________________
    ____________________________________________________
  7. Surgeries ____________________________________________
  8. Age at first menstrual period_____________________________
  9. Past history of STDS? No___ Yes(specify)___________________
  10. Ever had voluntary intercourse? No___ Yes(specify)____________
  11. Ever pregnant? No___ Yes(specify)_______________________
  12. Contraception: None___ Pill___ Condom___ Diaphram___
    IUD___ Other__________
  13. History of prior sexual mistreatment of patient?No___ Yes(specify)____
    _____________________________________________
    _____________________________________________

Comments:




Family and Social History:

Is there a further family history of:

128. Alcohol problems? No_______Yes(describe who)_______
129. Allergies? No_______Yes(describe who)_______
130. Bone problems? No_______Yes(describe who)_______
131. Cancer? No_______Yes(describe who)_______
132. Diabetes? No_______Yes(describe who)_______
133. DFCS problems? No_______Yes(describe who)_______
134. Drug problems? No_______Yes(describe who)_______
135. Easy bruising? No_______Yes(describe who)_______
136. Heart problems? No_______Yes(describe who)_______
137. High blood pressure? No_______Yes(describe who)_______
138. Legal/jail problems? No_______Yes(describe who)_______
139. Seizures? No_______Yes(describe who)_______
140. Physical mistreatment? No_______Yes(describe who)_______
141. Sexual mistreatment? No_______Yes(describe who)_______
142. Domestic violence? No_______Yes(describe who)_______
  1. How were you (the person(s) giving the history) treated as a child?




  2. Do you, the caregiver (male___ female___) perceive yourself to be in personal danger? No___ Yes (describe by whom) _____________



  3. Other comments

PHYSICAL EXAMINATION

Growth:

Height
146._____(cm,in) 147. %ile for age_____ 148. %ile for height_____

Weight
149._____(cm,in) 150. %ile for age_____ 151. %ile for height_____

Head circumference
152._____(cm,in) 153. %ile for age_____ 154. %ile for height_____

Body mass index (BMI)
155.__________

Examination

156. General appearance:________________________________
157. Head Normal_________Abnormal___________
158. Eyes Normal_________Abnormal___________
159. Ears Normal_________Abnormal___________
160. Nose Normal_________Abnormal___________
161. Mouth Normal_________Abnormal___________
162. Throat Normal_________Abnormal___________
163. Neck Normal_________Abnormal___________
164. Respiratory Normal_________Abnormal___________
165. Cardio-vase Normal_________Abnormal___________
166. Abdomen Normal_________Abnormal___________
167. Extremeties Normal_________Abnormal___________
168. Neuro/develop Normal_________Abnormal___________
169. Skin Normal_________Abnormal___________

Describe any significant findings:

Family and Social History:

Male

170. Tanner stage: I.___II.___III.___IV.___V.___
171. Skin Normal_______Abnormal______
172. Penis Normal_______Abnormal______
173. Testes Normal_______Abnormal______
174. Scrotum Normal_______Abnormal______
175. Perineum Normal_______Abnormal______
176. Anus Normal_______Abnormal______
177. Discharge? No_______Yes(specify)____________

Describe any abnormalities:

 

Female

178. Tanner stage: I.___II.___III.___IV.___V.___
  Normal Abnormal Describe
179. Skin ______ ______  
180. Anus ______ ______  
181. Perineum ______ ______  
182 Labia majora ______ ______  
183 Labia minora ______ ______  
184. Clitorus ______ ______  
185. Urethra ______ ______  
186. Peri-urethral area ______ ______  
187.Posterior fourchette ______ ______  
188. Fossa navicularis ______ ______  
189. Vagina ______ ______  
190. Vaginal discharge ______ ______  
191. Hymen (always describe) ______ ______  

Describe any additional abnormalities:

 

DATA

Lab

192. CBC: Normal_________Abnormal___________Value_________
193. Hgb Normal_________Abnormal___________Value_________
194. WBC Normal_________Abnormal___________Value_________
195. U/A Normal_________Abnormal(specify)___________
196. HCG Pregnant_______Not Pregnant_______Pending_______

Cultures

  Vagina Anus Urethra Throat
197. Gonorrhea _____ _____ _____ _____
198. Chlamydia _____ _____ _____ _____
199. Routine vaginal cx _____ _____ _____ _____
200. Other _____ _____ _____ _____

Photographs

  1. Coploscopic photos taken? Yes___No___
    1. Other photos taken? Yes___No___
    2. Who has these other pohotgraphs? Police___DFCS___Hospital/Center___
Consults? (check if applies)
204. Child Advocacy Center Obtained_____Recommend_____
205. Forensic pediatrics evaluation Obtained_____Recommend_____
206. Dentristy Obtained_____Recommend_____
207. Dermatology Obtained_____Recommend_____
208. Ob/gyn Obtained_____Recommend_____
209. Pediatric surgery Obtained_____Recommend_____
210. Other (specify)_______ Obtained_____Recommend_____

Comments:

IMPRESSIONS/RECOMENDATIONS

Impressions (list acute, chronic, developmental, family/social problems):



Recommendations:



Reporting (date/time/name of investigator):

  1. DFCS________________________
  2. Police________________________

Other comments:


Examiner_________________________________
Contact Number____________________________
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