The State of California requires that all health care providers screen their patients for domestic violence and report any injuries caused by domestic violence to law enforcement agencies. In order to make this requirement easier for you, the Health care Providers Domestic Violence Network, the District Attorney, the Department of Health and Human Services, and law enforcement agencies have developed a Sacramento County reporting form to be used by all mandated reporters. This form is understandable to law enforcement.
The form can be reproduced and used in your practice. Please discard any other report form you are currently using, so that we can obtain consistent complete information on every domestic violence injury.
In addition to the report form, there is also a sample protocol that addresses how to screen patients for domestic violence as well as how to report these incidents. Updated telephone numbers for law enforcement agencies and community resources/services are also provided.
Domestic Violence is a disease of our society, where the health consequences are frequently seen in all health care settings. No one alone can deal with this problem, but together we may be able to decrease the incidence of this unacceptable behavior in our community.
If you need immediate assistance, call 911.