Attachment 3_Authorization for Collection Form.pdf

This Authorization for Collection Form is a supporting document for Maine's Master Agreement for Sexual Assault Evidence Collection Kits. The form serves as an authorization instrument that enables designated healthcare providers and law enforcement agencies to collect sexual assault evidence kits in compliance with state protocols and procedures. The document establishes the framework for authorizing the collection, handling, and documentation of sexual assault evidence kits across participating Maine jurisdictions and healthcare facilities.

The form contains procedural requirements for authorized personnel to document and maintain chain-of-custody records for evidence collection activities. It includes identification fields for the authorized collector, victim information, case reference numbers, and collection dates and times. The authorization mechanism ensures accountability and standardization across all participating agencies and facilities involved in the sexual assault evidence collection process under the master agreement.