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Acute Health Care Management of Patients

Released May 7, 2019, DOD Instruction 6310.09 Health Care Management for Patients Associated with a Sexual Assault prescribes procedures to ensure comprehensive standards for providing health care in the Military Health System for patients who, during the course of receiving health care, disclose they have experienced a sexual assault or disclose they have committed, or are suspected to have committed, a sexual assault. The policy also includes health care management of children when a health care provider determines or suspects that sexual abuse has occurred.

It is important that individuals who have experienced a sexual assault understand the health care resources and reporting options available to them.

Regardless of DOD beneficiary status or location, victims of sexual assault are eligible for:

  • Emergency examination by a health care provider to assess and treat physical or psychological injuries that may have been sustained and provide referrals for additional care needed.
  • Formal Sexual Assault Forensic Examination (SAFE) to collect evidence to include specimens and photos. A SAFE is a voluntary forensic medical examination conducted by a trained health provider, a Sexual Assault Medical Forensic Examiner (SAMFE), which will preserve evidence of a sexual assault that can be used in criminal proceedings. It also includes a medical history. Testing, preventive treatment and follow-up care for sexually transmitted diseases or infections and/or pregnancy will also be provided.

Eligibility for other services may depend upon DOD beneficiary status:

  • Active-duty service members and their dependents can receive emergency services and follow-up care at any military treatment facility (MTF). They will also receive the services of a Sexual Assault Response Coordinator (SARC), Sexual Assault Prevention and Response Victim Advocate (SAPR VA) and Special Victims’ Counsel or Victims’ Legal Counsel (SVC/VLC). A SARC coordinates and manages care for a victim of sexual assault throughout the investigation and recovery. A SAPR VA provides support, education and resources to adult sexual assault victims and works with the SARC. An SVC/LVC is an active-duty judge advocate whose sole role is to represent victims in a confidential, attorney-client relationship, throughout the investigation and prosecution processes. SVCs/VLCs serve as a victim’s personal attorney at the military’s expense.
  • Civilian employees and their families in CONUS are eligible for emergency care at an MTF. OCONUS, in support of a mission, civilian employees and their families are eligible for emergency care at an MTF, and the employee can receive the services of a SARC and SAPR VA.
  • Contractors in support of a mission CONUS or OCONUS are eligible for emergency care at an MTF.
  • Retirees or members of the National Guard or reserves are entitled to emergency care and may be eligible for additional services.
  • Dependents are eligible to receive emergency care at an MTF. Providers will refer them for follow-on care, which may include referral to a Domestic Abuse Victim Advocate (DAVA) or Family Advocacy Program. A DAVA coordinates and manages care for a victim of sexual assault that occurs within a family or between intimate partners.

Reporting options:

  • Unrestricted Report: After an unrestricted report is made, DOD law enforcement begins an investigation. For active-duty service members, command and a SARC are notified. Unrestricted reports cannot be changed to a restricted report. DOD civilian employees and contractors are only eligible for unrestricted reporting.
  • Restricted Report: Service members and their family members over the age of 18 may choose to confidentially disclose a sexual assault to specific individuals (SARC, SAPR VA or health care personnel) through making a restricted report. Restricted reports do not trigger an investigation by DOD law enforcement. These disclosures are kept confidential and a victim can still elect to have a forensic medical examination. Restricted reports can be changed to unrestricted reports at a later date.
  • Required Legal Reporting: For those victims younger than 18, who have a disability, or are incapacitated, providers are required by law to report an assault to the authorities. State laws vary on who is required to report and the types of assault that must be reported.

Download or print the Sexual Assault Health Care Support for Patients fact sheet

Mental Health treatment options:

  • Mental health providers embedded within a unit can offer transitional treatment and referrals to service members for longer term treatment.
  • Behavioral health clinics at local military treatment facilities (MTFs) typically offer counseling and psychotherapy services; some MTFs offer specialized sexual trauma services.
  • Vet Centers are open to active duty service members in need of sexual trauma related mental health services, do not require a referral, and operate outside of the MTF and VHA electronic medical record system for increased anonymity.


Last Updated: March 25, 2024
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