Medical Examination of a Victim of Sexual Assault - police Form 3A

Uganda Police

This form, Police Form 3A, is a standardized medical examination report for victims of sexual assault in Uganda. It is divided into two parts: Part (a) is to be filled by a police officer requesting the examination, and Part (b) is for the medical practitioner to document their findings. The medical section covers victim particulars, history, general and specific physical examinations (including head, neck, chest, abdomen, limbs, genitals, buttocks, and anus), probable causes of injuries, sample collection for analysis, other investigations, and recommendations for referral or review. A pictogram is included for documenting injuries.