Sexual Assault Exams
All State of Mississippi Crime Laboratory Sexual Assault Evidence Collection Kits must be accompanied by the new Sexual Assault Examination Form. You can download the revised Child/Adolescent Examination Form, the Adolescent/Adult Examination Form and the New Non-Acute 72 Hours Child/Adolescent Examination Form. Deliver the form with the State of Mississippi Sexual Assault Evidence Collection Kit to the hospital or clinic conducting the examination. The hospital/clinic is responsible for submitting the form for payment. For further information call 1-800-829-6766.
- Sexual Assault Examination Payment Policy
- Download the sexual assault examination payment policy.
- Child/Adolescent Examination Form
- Download the Child/Adolescent Examination Form.
- Adolescent/Adult Examination Form
- Download the Adolescent/Adult Examination Form.
- Non-Acute 72 Hours Child/Adolescent Examination Form
- Download the Non-acute 72 hour child/adolescent sexual assault examination form.
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