A Guide to Understanding Your Medical Options After Sexual Assault

If you or someone you care about is experiencing a medical emergency, please call 911 or report to the nearest emergency room.

Sexual assault is a traumatic experience that may leave survivors feeling overwhelmed, uncertain, and unsure of where to turn. In Madison, Wisconsin, there are compassionate, specialized healthcare services available to support survivors in both their immediate medical needs and their long-term recovery. Common medical concerns following an unwanted sexual encounter may include: “Am I pregnant?” “Did I get a sexual disease?” “Was I drugged?” “Is my body okay?” A forensic nurse exam is a specialized medical exam performed by a trained healthcare professional, typically, a Sexual Assault Nurse Examiner (SANE)—who has expertise in both trauma-informed care and evidence collection. In Madison, WI a forensic nurse exam, SANE exam, or rape kit exam all have the same meaning.  Many survivors wonder, “can’t I just see my regular doctor?” While your primary care provider plays an important role in your overall health, a forensic nurse is specially trained to address the unique medical, forensic and emotional needs that can arise after experiencing an unwanted sexual encounter.  Most primary care providers receive limited education on forensic evidence collection, injury photography, and trauma informed documentation.  One of the biggest misconceptions survivors have is that seeing a forensic nurse means involving law enforcement. That is simply not true. Another common misconception around SANE exams is that you can only seek care if you remember everything that happened. That is simply not true.  SANE nurses are trained to understand how trauma affects memory, emotions, and the body.

Many survivors worry about being judged, blamed or forced to tell their story repeatedly.  The goal of a SANE nurse is to ensure survivors feel safe, respected, and in control throughout the process. You deserve care. It does not matter if you were using substances, what you were wearing or doing. It is not your fault.  Forensic nurses are uniquely trained in trauma-informed communication, evidence handling, documentation for legal use, and supporting survivors emotionally and physically.  A SANE’s role is to create a safe environment where survivors can move at their own pace and make informed choices regarding their care. The focus is not on “proving” what happened, the focus is on supporting you.

A SANE nurse works one on one with a survivor.  They have no other patients at the time they are doing your exam.

In Madison, WI there are multiple locations for the forensic nurse exam or SANE exam. Factors to consider when selecting a location for your exam include age, when it happened, comfort with an emergency room setting versus clinic setting, preference of appointment vs walk-in (which may involve long wait times), childcare needs, billing concerns and whether you want to show ID or insurance.

Understanding Your Medical Options After Sexual Assault, Timing Matters:

Seeking medical care within 120 hours (5 days) is very important for a variety of reasons including emergency contraception and evidence collection. Wisconsin allows for evidence to be collected for up to 120 hours, and sometimes longer in specific circumstances. If you suspect you were drugged or given a substance, the sooner you seek medical care the higher the likelihood of finding a substance on lab testing.  A forensic nurse will explain all available options for evaluation, treatment, and evidence collection clearly.

Survivors have multiple choices:

• Reporting to police right away and completing evidence collection
• Completing an undecided evidence collection (no immediate report – stored at the crime lab)
• Choosing medical care only without evidence collection (this may include a physical exam, lab tests, and treatment/medications as needed)

Undecided evidence collection allows a rape kit to be completed and preserved without contacting law enforcement. In Wisconsin, this evidence can be securely stored for up to 19 years, giving survivors time to decide what is right for them.  There is no right or wrong choice—what matters is what feels safest and most supportive for the survivor.

In Wisconsin survivors have the right to receive a forensic nurse exam / SANE exam / rape kit at no cost.  Some additional medical care (such as treatment of injuries or labs) may be billed in the hospital setting so it’s always appropriate to ask questions if cost is a concern.  Adult survivors can  receive free and confidential care regardless of immigration or insurance status. Many people think SANE nurses only perform “rape kits” or collection of evidence  but in reality SANE nurses  also assess injuries, provide medications, evaluate risks of pregnancy, answer questions about healing, and much more! Forensic exams serve two important purposes:

• Medical Care: Treat injuries, prevent infections, drug testing, and ordering medications such as emergency contraception or STI prophylaxis.
• Evidence Collection: Preserve physical evidence that may be used if a survivor chooses to pursue legal action.

Importantly, you can receive a SANE exam whether or not you decide to report the assault to law enforcement.

A common misconception is that you have to have visible injuries to seek a SANE exam – this isn’t true. In fact, most survivors do not have visible injuries following a sexual assault. Forensic nurses often hear, “I didn’t know if I could come in because it wasn’t that bad.”  Anytime someone experiences an assault or is questioning what happened, they have the right to seek care by a forensic nurse.

The Forensic Nurse Exam: What Survivors Should Know

Knowing what to expect can reduce anxiety. A forensic exam is conducted at the survivor’s pace, and every step is optional. You can pause, stop or decline any part of the exam at any time.  Bringing a trusted support person is encouraged, and advocates are available in Madison, WI through partnerships like DaneMAC and the Dane County Rape Crisis Center.  The forensic nurse exam process typically takes 2–4 hours, depending on the options you choose.

Let’s break down the steps of a forensic nurse exam or SANE exam:

1. 1. Check in and Consent:  You will be checked in privately. A forensic nurse or advocate will explain your options for care, and you will be asked to sign consent forms.  It’s important that consent is ongoing. You can change your mind at any time.  Survivors in Wisconsin are offered an advocate that can stay with them the entire time or leave.  In Madison, WI DaneMAC mobile forensic nurse exams partner with Dane County RCC Sexual Violence Resource Center for advocacy.
   2. Medical History:  You will be asked a few questions about your medical history, including your known allergies and current medications.  This is important information the SANE nurse gathers to know which medications will work best for you.
   3. Discussion about the assault: You will be asked questions about the assault. You can share what you remember and are comfortable sharing. Many survivors do not remember everything about the assault. This can be related to a normal trauma response.  Sometimes memory loss may also be due to alcohol or drugs. You may not have a clear memory or may have a vague sensation something happened but you’re not sure what. All are valid concerns and you can seek a SANE exam, sometimes called a “rape kit,” without full memory. For a variety of reasons, some survivors do not want to disclose a lot of details. Again, you still have the right to receive medical care, and consent is ongoing throughout that process.  You share what you are comfortable telling the forensic nurse.
   4. Physical Examination: In Madison, WI, a SANE exam is a lot like a routine physical exam (exam of your body) that you may have had for sports, or well check for an adult wellness exam, but with a more detailed observation of the skin and body. The forensic exam should not be painful. The SANE nurse will explain each step before proceeding. You are in control of what happens.
      • If you choose evidence collection this will happen as the forensic nurse examines your body. There are a lot of misconceptions about evidence – nothing should hurt, forensic nurses do not pluck hair, and even if you have showered multiple times or changed clothes evidence may still be present. Forensic nurses will move at your pace and you can take as many breaks as you need.  During a “rape kit” or SANE exam evidence may include swabbing the skin with q-tips, photographs of injury, collection of debris from the body if present, urine sample, and collection of clothing worn when the assault happened if it is available. During the process the forensic nurse will talk with you about what is happening every step of the way to ensure you feel comfortable. Asking questions during the SANE exam is your right as a patient. In fact, nurses will encourage you to ask questions if needed so that patients can fully understand each step of their care.
      • Many survivors want to know if their body is okay and are interested in medical care only. This includes care such as a physical exam, treatment of injuries, sexually transmitted infection (STI) testing, drug testing,  preventative medication and more. Some survivors do not want a physical exam, only preventative medications or STI testing. SANE nurses are trained to develop a custom care plan to meet each patient’s individual needs, and it is okay for this to look different for each person. You can decline any part of the exam, at any time.
   5. In a SANE exam, the nurse will discuss your options for treatment – including medication management. For patients with the ability to become pregnant, preventative medication called emergency contraception may be considered.  Medications for the prevention of STI’s will also be discussed with you. A forensic nurse will also screen your risk for HIV exposure and transmission,  and discuss the possible preventative medications available. A SANE nurse will also create follow up plans such as meeting with your primary care provider to help with ongoing medical needs and community referrals.  In Madison, WI a forensic exam will end with review of  a discharge summary, which will include instructions for any medications prescribed, and a plan about a follow up call / message with the forensic nurse. It’s important for your health to follow the directions for all medications given from the forensic nurse.
      • Depending on the options you choose, if evidence is collected  the forensic nurse will hand off your evidence kit to the police or arrange for it to be stored at the local crime lab.  For undecided evidence collection, the crime lab does not contact you – if you decide you want to report to police, you may reach out to the advocate team that was at your exam for assistance and support. In Wisconsin all evidence kits will have a barcode to identify you, not your name or contact information. SANE nurses do not receive the results from toxicology or evidence kits.  If you select undecided evidence, the evidence will not be processed but will be preserved and stored in accordance with Wisconsin law.

Having a forensic exam completed does not guarantee your case will be charged, go to court, or that you will have to testify in court.   Forensic nurse exams and medical care after sexual assault are designed to prioritize the survivor’s well-being above all else.  In Madison, WI, access to trained SANE nurses and advocacy networks ensures survivors receive compassionate, respectful, and empowering care.  Whether you are seeking medical care, exploring your options, or supporting someone else, help is available. You are not alone, and there are professionals and organizations ready to support you every step of the way.

DaneMAC Mobile Nurse team offers an on call nurse to answer questions they can be reached at 608.492.2611

Setting Expectations: What Forensic Nurses Cannot Provide

A forensic nurse cannot tell you what happened. We acknowledge that it is distressing to many survivors to not know what happened, but forensic nurses cannot determine whether an assault occurred. We document injuries, collect evidence, assess medical concerns, and listen to a survivor’s account. Additionally, determining whether a crime occurred is a legal decision, not a medical decision.  Forensic nurses cannot prove guilt or innocence. Our role is to objectively document findings, collect evidence, and provide medical care. Investigators, prosecutors, judges, and juries make legal determinations.

A forensic nurse will not be able to tell you if there are multiple persons’ DNA on your body or if DNA is found.  DNA is not always present, recoverable, or linked to a specific person.  Many factors affect whether DNA evidence is recoverable.  The information obtained from the SANE exam will be shared with the  police department handling your case.

A forensic nurse cannot direct or control law enforcement investigations. We can provide documentation and evidence when appropriate, with patient consent.  A forensic nurse document / chart  becomes evidence along with the “rape kit”. Evidence may include photographs in some cases.

A forensic nurse can provide information and referrals, but we cannot issue legal orders or provide legal representation for things such as a restraining order. For legal concerns, Hazel Helps includes a partnership with Lotus Legal Clinic.

While forensic nurses are extremely skilled at providing emotional support, crisis intervention, and education, they cannot provide therapy.

Forensic nurses often wish more people understood that a forensic nurse’s job is not to determine whether someone is telling the truth.  Our job is to provide compassionate care, document objective findings, preserve evidence, and ensure survivors have the information they need to make informed decisions that are right for them.

Understanding Sexual Assault Forensic Exams (SANE Exam)

A Sexual Assault Nurse Examiner (SANE) exam is a specialized medical and forensic evaluation conducted for individuals who have experienced sexual assault or abuse. The primary goal of a SANE exam is to provide compassionate care, address immediate health concerns, and collect evidence that may be used in a legal investigation. These exams are performed by trained healthcare professionals, typically registered nurses, who have completed specialized education in forensic nursing and trauma-informed care.  These can also be called a “rape kit” or forensic nurse exam.  In Madison,WI we call them Forensic Nurse Exams or FNE.

At its core, a SANE exam focuses on the patient’s well-being. When someone arrives at a community based forensic nurse program or healthcare facility requesting a SANE exam, their consent and comfort guide every step of the process. Patients can choose what parts of the exam they want to participate in and can stop at any time. The emphasis on autonomy is essential, as survivors often feel a loss of control, and restoring that sense of choice can be an important part of their healing.  A forensic nurse has multiple hours of training in addition to their medical license training to become a forensic nurse.

The exam begins with a medical assessment. The SANE nurse will ask about the patient’s health history and explain the process in detail. This conversation may include questions about the assault, but only to the extent necessary for medical care and evidence collection. The patient is never required to share more than they are comfortable with. The medical portion may involve treating injuries, testing for drugs / substances, and addressing concerns such as sexually transmitted infections (STIs) or pregnancy. Preventive medications, like emergency contraception or antibiotics, may be offered.  In Madison, WI forensic exams are confidential and free in all locations, additionally they do NOT require a report to law enforcement to seek care.

A key component of the SANE exam is forensic evidence collection, often referred to as a “rape kit.” Evidence may include clothing, biological samples (such as swabs), photographs of injuries, and documentation of findings. This process is conducted with great care to preserve the integrity of potential evidence. Importantly, patients have the option to have evidence collected even if they are unsure about reporting the assault to law enforcement. In Wisconsin, evidence can be stored anonymously for 19 years, giving survivors space to decide their next steps.

Another critical aspect of the SANE exam is emotional support. Forensic  nurses are trained in trauma-informed care, meaning they understand the psychological impact of an unwanted sexual encounter  and strive to create a safe, supportive environment. In Madison, WI DaneMAC’s mobile forensic nurse team  also teams with advocates, who are professionals who provide emotional support, explain legal rights, and help connect survivors with additional resources such as counseling or support groups.

Confidentiality is a cornerstone of the SANE exam. While policies vary by location, healthcare providers generally explain what information may be shared, particularly in cases involving minors or situations where mandatory reporting laws apply. Adults have more control over whether to involve law enforcement.

Timing can be an important factor in a SANE exam. While exams are encouraged within a few days of the assault up to 120 hours, patients can still seek medical care and support at any time after an assault. Even if forensic evidence collection is no longer possible, medical treatment and emotional care remain essential and available.

For many survivors, undergoing a SANE exam can feel overwhelming. However, it is designed to be as respectful and empowering as possible. It not only addresses immediate health needs but can also play a crucial role in the pursuit of justice if the survivor chooses that path.

In summary, a SANE exam is a comprehensive, patient-centered approach to care after sexual assault. It blends medical treatment, forensic science, and emotional support into one coordinated process, all while prioritizing the survivor’s choices and dignity. By offering both care and the option to preserve evidence, SANE programs are a vital resource in helping individuals begin to heal and regain a sense of control after trauma.

Can you get a rape kit without reporting to police?

If you’ve experienced sexual assault, one of the most important things to know is that you still have control over what happens next. Many people hesitate to seek medical care because they’re worried it will automatically trigger a police report. The good news is: in most places across the United States, including Madison, Wisconsin, you can receive a SANE exam with evidence commonly called a “rape kit” without reporting to law enforcement.
This option is often referred to as a “non-report” or “anonymous”  forensic nurse exam or SANE exam, and understanding how it works can help you make the choice that feels right for you.  Wisconsin calls this option undecided evidence collection during a SANE exam.
Hospitals and community based Forensic Nurse programs, in Wisconsin, allow survivors to have evidence collected and stored without making an immediate police report. This gives you time and space to decide what you want to do next.

The evidence is typically stored for a set period (19 years in Wisconsin)
During that time, you can choose to file a report later if you wish
If you don’t want to report at all, that choice is respected
This approach is designed to reduce pressure and support survivors in making decisions at their own pace.

If you choose not to involve law enforcement right away:

You still receive full medical care. The forensic nurse exam will include treatment for injuries, pregnancy prevention if desired, possible drug testing, and testing or prophylaxis for sexually transmitted infections (STIs).
Evidence is collected and preserved. The kit is labeled in a way that protects your identity or keeps it confidential until you decide what to do next. In Madison, WI we use a barcode system.
You are not required to speak to the police. SANE nurses would never force you into a report.
In Madison, WI a trained advocate from Dane County Rape Crisis Center, Sexual Violence Resource Center, will be available to support you during the exam, explain your rights, and help you make informed decisions.

Every survivor’s situation is different. Some reasons people choose not to report right away include:

Feeling overwhelmed or not ready to talk about what happened
Concern about safety or retaliation
Lack of trust in the legal system
Wanting time to process and consider options
Knowing the person who harmed them
These are all valid reasons. What matters most is that you are in control of your decisions.

You deserve care, dignity, and choices after an assault. Getting a “rape kit” does not mean you are committing to a police report. It simply preserves your options while prioritizing your health and well-being.

If you’re reading this and wondering what to do next, know this:
You don’t have to decide everything right now. You just have to take the next step that feels safest for you.

And whatever you choose, you are not alone.

Understanding the SANE Exam

A forensic nurse exam—often called a Sexual Assault Nurse Examiner (SANE) exam—is designed to provide both medical care and the option to collect evidence after a traumatic experience. For many people, not knowing what to expect can add anxiety to an already overwhelming situation. Understanding the process can help you feel more informed, supported, and in control.

When you arrive for a forensic nurse exam, your safety and comfort are the top priorities. You’ll be greeted by a specially trained forensic nurse who understands trauma-informed care. This means they will move at your pace, explain each step clearly, and ensure you have control over what happens. You can pause or stop the exam at any time, and your consent is required for every part of the process.

Your physical health is the most important concern. The SANE nurse will begin by addressing any urgent medical needs, such as injuries that require treatment. They may also discuss options for preventing sexually transmitted infections (STIs) and pregnancy, drug testing, depending on your situation.  Some survivors question should I do this exam because it “wasn’t that bad” forensic nurses do so much more than an evidence collection kit, and are truly the best resource for medical care following an unwanted sexual encounter.

You’ll be asked about your general health history and any medications you take to ensure safe care. This portion is similar to a typical medical visit but approached with extra care and sensitivity.
The forensic nurse will gently ask questions about what happened. This helps guide both your medical care and any potential evidence collection. It’s important to know you are not required to share every detail. You decide what you want to disclose, and you can skip any questions.  The goal here is not interrogation—it’s to ensure appropriate care and documentation.  If you choose to proceed, the SANE nurse may collect forensic evidence. This process is often referred to as a “rape kit,” but it’s completely optional. You can consent to some parts and decline others. Evidence collection may include:
Swabs from the body to collect possible DNA
Collection of clothing or personal items
Photographs of injuries, taken respectfully and only with permission
Documentation of injuries and physical findings
The exam is conducted in a private setting, and the forensic nurse explains each step before it happens. While some parts may feel uncomfortable, they should not be painful. If anything does feel uncomfortable, you can ask to pause or stop.
The SANE nurse carefully documents findings, which can be used later if you decide to report to law enforcement. In Madison and all of Wisconsin, you can have evidence collected without immediately filing a police report. This allows you time to decide your next steps.  Confidentiality is taken seriously. The SANE nurse will explain how your information and any evidence will be stored and who has access to it.

One of the most important aspects of a forensic nurse exam is that it is centered on your autonomy. You are in control every step of the way—what you say, what you do, and what you consent to.

While the idea of a forensic exam can feel intimidating, it is ultimately a compassionate, patient-centered process designed to support your health, preserve your options, and respect your decisions.

What can a Forensic Nurse Provide After a Sexual Assault

When physical health care and the justice system intersect, forensic nurses play a critical and compassionate role. At Hazel Helps, we believe in empowering individuals with knowledge and access to care—and understanding what a forensic nurse provides can be an important step for anyone navigating trauma, violence, or legal processes. A forensic nurse is most often a  registered nurse who has received specialized training to care for patients who may be involved in some legal action. This often includes survivors of sexual assault, domestic violence, child or elder abuse, human trafficking, and other forms of interpersonal violence. What sets forensic nurses apart is their ability to combine trauma-informed medical care with evidence collection and documentation that can be used in court if a patient chooses to pursue legal action.  This dual role means that patients don’t have to choose between receiving medical attention and preserving their legal options—they can receive both in one safe, supportive environment.
At the heart of forensic nursing is compassionate care. Forensic nurses are trained to work with individuals who have experienced trauma, and they prioritize emotional safety alongside physical health. This includes:
Treating injuries and addressing immediate medical needs
Conducting thorough but respectful physical exams
Offering preventative care, such as medications to reduce the risk of infection or pregnancy
Supporting patients’ emotional well-being during a vulnerable time
Most importantly, forensic nurses respect patient autonomy. Individuals are never forced to undergo SANE exams or report to law enforcement, they are given options and allowed to make their own decisions at every step.
One of the most well-known roles of forensic nurses is evidence collection, especially in cases of sexual assault. SANE exams are conducted with great care and attention to detail. Forensic nurses may:
Collect and preserve physical evidence (such as swabs, clothing, or trace materials)
Take photographs of injuries for legal documentation
Record detailed notes that may later support an investigation or court case
Maintain proper chain of custody for all collected evidence
This work is essential because it ensures that evidence is gathered professionally and respectfully, increasing its reliability if the patient decides to take legal action.
Beyond medical care, forensic nurses act as advocates for their patients. They help individuals understand their rights and options, including whether or when to report an incident. In Madison, WI forensic nurses also collaborate with victim advocates from Dane County Rape Crisis Center Sexual Violence Resource Center.
SANE nurses also contribute to the justice system by serving as expert witnesses in court. Because they are trained in both healthcare and legal standards, they can clearly explain medical findings and evidence in a way that is understandable and credible. Their testimony can help:
Clarify the extent of injuries
Explain how evidence was collected and preserved
Provide context for trauma responses
This can be particularly important in cases where physical evidence or medical interpretation plays a key role.
On Hazel Helps the DaneMAC forensic nurses are not only responders—they are educators and advocates for prevention. Many are involved in community outreach, helping raise awareness about violence, consent, and available resources. They also train other professionals to recognize signs of abuse and respond appropriately.

STI Testing After Sexual Assault: What You Need to Know

After a sexual assault, many survivors have questions about their health, including whether they should be tested for sexually transmitted infections (STIs). The answer is different for every person, but understanding your options can help you make informed decisions about your care.

At Hazel Helps, we believe survivors deserve compassionate, trauma-informed healthcare that puts them in control. Whether an assault happened hours ago, days ago, months ago, or even years ago, you can seek medical care and STI testing when you are ready.

Why STI Testing After A Sexual Assault Matters

Sexual assault can involve exposure to sexually transmitted infections, but it is important to remember that exposure does not mean you will develop an infection. STI testing or preventative medication is one way to protect your health, answer questions, and provide peace of mind. Some STIs can cause symptoms such as:

Pain or burning with urination
Unusual discharge
Pelvic pain
Sores or rashes
However, many STIs have no symptoms at all. Testing may be the only way to know if an infection is present. Survivors in Wisconsin need to understand certain positive results have to be reported to public health. SANE exams are confidential but we have to report certain STI  infections.

When Should You Get Tested for STIs After an Unwanted Sexual Encounter?

The timing of STI testing depends on several factors, including when the assault occurred and whether you are experiencing symptoms.

If the assault happened recently, a forensic nurse can discuss options for preventive medications that may reduce the risk of certain infections before they develop. This medical care is confidential and no calls are made to public health.

Most testing available in Madison,WI is most accurate several days after the assault occurred, while others may require follow-up testing weeks or months later. Your forensic nurse can help determine the best testing schedule for your situation.

Remember: there is no “wrong” time to seek care. Even if significant time has passed since the assault, STI testing and medical support may still be beneficial. Preventive medications offered are antibiotics that prevent the infection from developing.

What Happens During STI Testing?

Many survivors worry STI testing will be painful, invasive, or requires a SANE physical exam. In reality, testing options are often simple and can include:

A urine sample
A blood test
A self-collected swab
A provider-collected swab, if needed
Your SANE nurse should explain every step and obtain your consent before any testing occurs.

You have the right to ask questions, decline any part of an exam, or stop at any time.

What Every Survivor Should Know: STI Testing Does Not Require a Police Report

One common misconception is that survivors must report to law enforcement to receive healthcare after a sexual assault.

This is not true.

You can seek STI testing, medical care, and support services whether or not you choose to involve law enforcement. Your health and well-being matter regardless of what reporting decisions you make.

How a SANE Nurse can Support Survivors, More Than Just STI Testing

Medical care after a sexual assault is about more than screening for infections. A forensic nurse can also discuss:

Pregnancy concerns and emergency contraception
Injury assessment and treatment
Safety planning
Emotional support resources
Counseling and advocacy services
Follow-up healthcare needs
The goal is to address your physical and emotional health in a way that feels safe and supportive.

Hazel Helps is here when you’re ready. Every survivor’s journey is different. Some people seek care immediately. Others may wait days, months, or years before reaching out. There is no timeline for healing.

At Hazel Helps, survivors can connect with a forensic nurse, explore resources, schedule an appointment, or simply learn about their options in a confidential and supportive environment.

If you have questions about STI testing after a sexual assault, know that you do not have to navigate them alone. Compassionate, trauma-informed care is available, and you deserve access to information, support, and healthcare that respects your choices every step of the way.