determination about forensic evidence collection, remember that the details of the event can become more specific over time The provider should document the history source, a description of the event, and use quotations when documenting the exact words from the patient’s disclosure when possible Document the witnesses present during the interview in the medical record Perform and document a complete physical examination including all injuries sustained Perform the examination with a chaperone, regardless of the gender of the patient or provider This chaperone should be a trained member of the medical staff who can assist in examination procedures and serves as an unbiased witness A parent or another familiar adult can remain with the child to provide support and comfort Distraction techniques, pain control, anxiolysis, or sedation may be required in some situations The anogenital examination includes careful inspection of the penis and scrotum in males, the mons pubis, the labia, vaginal opening, and hymen in females, and the anus in all patients A speculum or bimanual examination is rarely required in adolescent patients It may be indicated if there is significant vaginal bleeding, or concern for a retained vaginal foreign body It should be avoided in prepubertal patients Photo documentation of all injuries is recommended It is useful to photo document a normal genital examination as well, to avoid risk of not detecting subtle, potentially forensic findings While a colposcope provides magnification for optimal visualization and high-quality photo documentation, there are other digital health advances that EDs are using that may obviate the need for this equipment In specific, digital photograph systems that are integrated with the electronic health record are being used and provide excellent photo documentation with little training required to provide diagnostic quality images for peer and quality improvement review Regardless of the equipment and system used, the important caveat is: (1) all forensic examinations include photo documentation that is conducted in a secure, protected fashion; and (2) photo documentation is of diagnostic quality to adequately represent the examination and potential findings Written documentation detailing the examination must be included in the medical record Of note, urgent physical examination is not required if the assault occurred >72 hours prior to presentation, unless the child/adolescent has ongoing symptoms including but not limited to, significant abdominal pain