As a result of the Violence Against Women Act (VAWA) Reauthorization of 2005, State Governments must develop processes by which victims of sexual assault can receive a forensic medical exam without being required to cooperate with law enforcement, or participate in the criminal justice system. The benefits and barriers of five different models are reviewed: nonreport evidence collection, anonymous report, confidential mandated reporting, victimless prosecution or nonparticipation approach, and the military model of restricted and unrestricted reporting. As a result of VAWA mandates, hospitals and forensic nursing programs are confronted with additional issues related to evidence handling, transfer, and storage. Implications: Forensic nurses will play an important role in bringing their individual jurisdictions into compliance with the VAWA mandates. (Published Abstract)