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IMPORTANT FORMS for New Hampshire SANE Nurses
Sexual Assault Exam Database
Click Here for the Sexual Assault Exam Database
Forms should be returned to the attention of: Pamela Carbee or Jennifer Pierce-Weeks. You can mail them to: NHCADSV, PO Box 353, Concord, NH 03302, or you can fax them to (603) 228-6096
Currency of Practice Completion Record
Click Here for the Currency of Practice Completion Record Form
Forms should be returned to the attention of: Pamela Carbee or Jennifer Pierce-Weeks. You can mail them to: NHCADSV, PO Box 353, Concord, NH 03302, or you can fax them to (603) 228-6096
The Adverse Childhood Experiences Study
The Effects of Adverse Childhood Experiences on
Adult Health and Well Being
A Decade-long and Ongoing Collaboration between Kaiser Permanente’s Department of Preventive Medicine in San Diego, California, and the Centers for Disease Control and Prevention. For more information on this study go to www.acestudy.org. (click on link)
ACE QUESTIONAIRE
Click on ACE Questionaire to review and print the questionaire.
Healthcare Provider Screening Video:
Three
Scenarios
Routine Confidential Screening
For prevention, identification, and referral.
Video Purpose
The purpose of this video on routine confidential screening for domestic violence in the health care setting is to demonstrate effective methods of screening and interventions for health care providers. Secondarily, the video identifies a variety of ways in which the patient experiencing domestic violence may present, and successful ways of intervening.
Scenario 1 - Direct Disclosure
Scenario 2 - Reluctant Disclosure
Scenario 3 - Teen Dating Violence
Important Disclosure
While each screening scenario depicts the health care professional offering immediate services from the local domestic violence crisis center, this is not always possible. For this reason, we recommend that each individual provider establish a relationship with the local crisis center, as well as an understanding of the services they are able to provide, prior to offering these services to any patient.
To request a VHS or DVD copy of this video Contact: Pamela Carbee Be sure to state whether you wish the screening video on VHS or DVD.
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