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A. Foundation for Response During the Exam Process. A1. Principles of Care. A2. Adapting Care for Each Child. A3. Coordinated Team Approach. A4. Health Care Infrastructure. A4a. Pediatric Examiners. A4b. Facilities. A4c. Equipment and Supplies. A5. Infrastructure for Justice System Response During the Exam Process. A5a. Reporting. A5b. Confidentiality and Release of Information. A5c. Evidentiary Kits and Forms. A5d. Timing of Evidence Collection . A5e. Evidence Integrity. A5f. Payment Issues. B. Exam Process. B1. Consent for Care. B2. Initial Response. B3. Entry into the Health Care System. B4. Written Documentation. B5. Medical History. B6. Photo-Documentation. B7. Examination. B8. Evidence Collection. B9. Sexual Abuse Facilitated by Alcohol and Drugs. B10. Sexually Transmitted Disease Evaluation and Care. B11. Discharge Planning and Follow-Up Care. Glossary and Acronyms. References. Appendix 1. Tanner Stages of Sexual Maturation . Appendix 2. Illustrations of Exam Positions and Techniques. Appendix 3. Labeled Diagrams of Genital Anatomy. Appendix 4. Customizing a Community Protocol. Appendix 5. Impact of Crawford v. Washington and The Confrontation Clause. Appendix 6. Initial Response Algorithm. Appendix 7. Care Algorithm. Appendix 8. Prepubescent STD Testing Algorithm. Appendix 9. HIV Testing nPEP Algorithm. Appendix 10. Participants in Protocol Development.