Reporting to Hospital for Evidence Collection 

Before we begin, take a purposeful pause. You’ve experienced something deeply traumatic, and it’s okay to take a moment to breathe. Whatever choices you make from here are yours to make. You are not alone. You have the right to seek support and care at your own pace.

Remember, there is no right or wrong way to move forward. Whether you choose to report, undergo a medical examination, or simply speak to someone about your experience, every step is valid and entirely up to you.

Step-by-Step Guide: What to Expect When Reporting to Hospital or Health Centre 

Important Note: The following information contains an ideal response by hospitals and health centres when reporting for care following a sexual assault. Due to nursing shortages and internal policy management, you may experience extended wait times, gaps in accessibility to evidence collection, and a lack of access to support services. 

If you decide to undergo forensic evidence collection via a sexual assault evidence kit (SAEK) examination, here's what to expect: 

1. Arrival at the Hospital

•  When you arrive, you will likely be seen in emergent care. Let the triage staff know you’ve experienced a sexual assault.
•  Please note that some hospitals have specialized Sexual Assault/Domestic Violence Treatment Centres (SADVTC) with trained professionals who provide trauma-informed care. In some provinces and territories, you may be able to access care through a Sexual Assault Response Team (SART). In limited provinces such as Alberta, doctors are responsible for evidence collection, but the majority of care and evidence collection services across Canada are administered by nursing staff. 
•  You will likely be asked to wait in the emergency room waiting area. While this is not ideal, it is standard practice across the majority of provinces and territories. Some hospitals and health centres are equipped with family rooms, available to families experiencing grief, trauma, etc. You may request to wait in this area, though there is no guarantee it will be available. 

•  Depending on where you access care, you may see a physician for a physical examination before you see a nurse or doctor to undergo forensic evidence collection via a Sexual Assault Evidence Kit (SAEK).  Procedure differs based on which province or territory you access care in, whether or not the facility has specialized services for sexual assault and domestic violence treatment, and whether or not the hospital or health centre has consciously tried to improve care and support for survivors of sexual assault. 

2. Meeting the Nurse or Advocate

•  Depending where you access care, you may be introduced to a nurse, social worker, or advocate who specializes in supporting survivors. They will explain the process, answer any questions, and ensure you understand your options. 
•  If you are reporting a sexual assault in a community without a nurse or advocate available to you, here are some helpful resources. 

3. Undergoing a Physical Examination and Sexual Assault Evidence Kit (SAEK) Examination 

•  You will be brought to a private room to meet with a nurse or doctor to begin your forensic evidence collection examination. It is your decision if you would like to undergo this examination, and which aspects of the documentation process you would like to answer.
•  For a breakdown of what is included in a SAEK, and what steps are taken during the examination process, please skip down to the next section.  

4. Consent 

•  Before any examination begins, you will be asked to give informed consent for each step. You can decline any part of the process you’re not comfortable with. The process will not proceed without your informed consent.

•  Informed consent is defined as: permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits.
•  Before undergoing any elements of the examination process, you are entitled to ask questions, choose not to participate in certain elements of the examination or documentation process, and take pauses throughout the exam.

5. Medical Examination

During the medical examination, a healthcare provider will assess your overall health and check for any injuries resulting from the assault. This portion focuses on your immediate medical needs and may include:

•  Treating visible injuries, such as bruises or cuts.
•  Offering medications to prevent sexually transmitted infections (STIs) and emergency contraception to prevent pregnancy if needed.
•  Discussing any symptoms or concerns you may have, such as pain or discomfort.
•  Ensuring that you feel supported and informed throughout the process.

This step is centered on your well-being and ensuring you receive any necessary medical care, whether or not you proceed with evidence collection.

6. Evidence Collection

The forensic nurse examiner will collect evidence, which may include:

•  Swabs from areas of the body where evidence might be present.
•  Samples of clothing or other personal items.
•  Fingernail scrapings or hair samples.
•  Documentation of injuries, including photographs (with your permission).

7. Discussion of Reporting Options

You’ll be provided with information about reporting the assault to law enforcement. If you’re unsure about reporting, many hospitals can store the evidence securely while you decide.

8. Follow-Up Care

Hospital staff should connect you with resources for follow-up care, including counseling, legal support, and community services.

If you are not provided with these resources, please reach out to our team at [email protected]. 

A Note for Survivors

Seeking care after an assault is an incredibly brave decision. Whether you choose to report or not, your well-being is what matters most. 

What is a Sexual Assault Evidence Kit?

A sexual assault evidence kit, also known as a “rape kit,” is a critical tool used to collect and preserve evidence following a sexual assault. It is designed to document physical evidence that may assist in a criminal investigation if the survivor decides to report the assault. This guide outlines the components of the kit and the steps involved in evidence collection based on Canadian guidelines.

Important Note

Participation in the evidence collection process is entirely voluntary. Survivors have the right to stop or skip any step at any time. Consent is required for each part of the process. The evidence collected will be stored securely, and in many provinces, survivors may have the option to delay reporting to law enforcement.

Step-by-Step Process

Below is an overview of the steps typically followed during evidence collection:

1. Initial Meeting and Explanation

   • The healthcare provider or forensic nurse (Sexual Assault Nurse Examiner - SANE) will explain the evidence collection process in detail and answer any questions. Survivors are given the opportunity to decide which steps they are comfortable with.

2. Consent and Documentation

   • The survivor is asked to review and sign consent forms, ensuring they fully understand each part of the process. These forms detail what evidence will be collected and how it will be used or stored.

3. Clothing Collection

   • Survivors may be asked to provide the clothing they were wearing during the assault. These items are placed in individual evidence bags. If necessary, alternative clothing will be provided.

4. Swabs and Biological Samples

   • Swabs are taken from areas of the body that may contain evidence, such as the mouth, genitals, or under nails. This step is conducted with great care and sensitivity.

5. Comb and Hair Collection

   • A comb is used to collect hair or fibers from the survivor’s body. Hair samples may also be taken directly from the scalp or pubic area, depending on the circumstances.

6. Photographic Documentation

   • With the survivor’s permission, photographs may be taken to document visible injuries such as bruises, cuts, or other marks. This step is optional, and survivors can decline.

7. Injury Assessment

   • The healthcare provider will conduct a detailed assessment of injuries, documenting findings and offering medical care as needed.

8. Sample Collection for Toxicology (if applicable)

   • If there is a concern about drug-facilitated sexual assault, urine and blood samples should be collected to test for the presence of substances.

9. Packaging and Secure Storage

   • All collected evidence is carefully sealed in a  tamper-proof box and labeled. It is stored securely, either in the hospital, police station, or a forensic facility, depending on provincial or territorial protocols.

10. Discussion of Reporting Options

    • The survivor is informed about their options for reporting to law enforcement. In many provinces, evidence can be stored for a period of time to allow the survivor time to decide if they wish to report to police. 

Survivor Support During the Process

Throughout the examination, survivors are entitled to bring a support person to accompany them and provide emotional support. If you do not wish to bring someone with you, but require support, you may contact your local victims services or request the support of a social worker if the hospital or health centre has them on staff. SAEK examinations are intended to be performed by trauma-informed healthcare providers. We note that in some understaffed health centres and hospitals, medical professionals administering SAEK's may not use the most updated sensitivity practices.

She Matters seeks to enhance sexual assault reporting practices, ensuring survivors receive emotional support and aftercare resources regardless of their geographical location. If you reside in a community that would benefit from support to enhance their services for sexual assault survivors, please let us know by emailing [email protected]. 

Final Note

Forensic evidence collection is an important tool for those who choose to engage with the legal system, but the decision to proceed with the reporting process is always up to the survivor. Your rights and comfort are the priority at every step of the process.