Survivor Name

Survivor Contact

Case Details

Names

Gender

Phone

Type of Violence
Economic Violence
Emotional Violence
Physical Violence
Relationship Control
Sexual Violence

Services Required
Abortion counselling/information
Advocacy for law reform and implementation
Collection of forensic evidence
Community awareness raising and sensitization
Community mobilization
Engaging men and boys as agents of change
Ensuring the safety of the survivor
Evaluation and treatment of injuries
Forensic examination and documentation (including Police Form 3)
HIV diagnostic testing and counselling
Identification/screening for IPV
Investigation
Issuing the police medical report form
Parent education programs and support groups for families affected by IPV
Peer or relationship interventions
Post-abortion care
Pregnancy testing
Provision of EC (Emergency contraception)
Provision of post-exposure prophylaxis (PEP)
Psychosocial counselling
Referral
Referrals to police and social support sectors
Screening for sexually transmitted infections
Signing of the police medical report form
Social change media and communication
Statement-taking and documentation
Storage of forensic evidence
Tool free lines
Trauma counselling
Treatment for sexually transmitted infections
Vaccination for Hepatitis B and Tetanus
Whole school interventions
Witness protection
Women economic empowerment and combined with gender training