This form records information on an experience of intimate partner violence (IPV) or sexual violence (SV), the characteristics and medical history of the survivor, the clinical examination, the survivor’s emotional state, laboratory tests conducted, legal evidence collected, care received and referral to professionals and agencies for further support and care. The form is aligned with the World Health Organization (WHO) “Health care for women subjected to intimate partner violence or sexual violence. A clinical handbook” (World Health Organization, 2014) and with the “National Clinical and Policy Guidelines on Intimate Partner Violence and Sexual Violence: Trinidad and Tobago” (Ministry of Health of Trinidad and Tobago and Pan American Health Organization, 2022). The content and design were informed by consultations with health-care providers in the Ministry of Health and the five Regional Health Authorities of Trinidad and Tobago, to ensure local applicability and relevance. The form enables documentation of cases of IPV and SV in line with international best practice in care and support of survivors, based on principles of human rights and gender equality. Accurate documentation of violence, its consequences and the responses by the health system are important to inform ongoing sensitive care and support of good quality.
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