SARC COVID-19 screening tool

Date: Time of call:
SARC staff name: Designation:
Complainant name: Date of birth:
Police or self-referral:
Police reference: SARC number:
Caller’s name: Caller’s designation:
Contact telephone number and email (more than one if possible):

Please advise complainant / referrer that a forensic medical examination cannot be organised until the following information is provided:

  Complainant Any person planning to accompany complainant
1. Have they had contact with a known or suspected COVID-19 positive person in the last 14 days?
2. Do they have influenza like illness?

Fever ≥37.8°C and at least one of the following respiratory symptoms, which must be of acute onset: persistent cough (with or without sputum), hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing).

3. Do they feel unwell? If so, how?
4. When did they first have these symptoms?
5. Have they contacted 111? When?
6. If so, what was 111 advice?
7. The above details have been provided by whom?


Client name: SARC number:

These details need to be discussed with a Forensic Clinician

Name of Forensic Clinician making decision:

Discussion details:

Assign complainant to the following categories:

A. Asymptomatic and no apparent risk of COVID-19
B. Known COVID-19  or with symptoms suggestive of COVID-19

Decision after triage by Forensic Physician

Option Decision Arrangements made are:
Examination at SARC
Arrange for telephone consultation (police referral)
Arrange for telephone consultation (self-referral)
Client has COVID-19 or has symptoms suggestive of COVID-19 but requires face to face FME


Forensic Clinician name: GMC /NMC number:
Forensic Clinician signature:
Date and time: