Offered by the International Association of Forensic Nurses (IAFN), the Sexual Assault Nurse Examiner – Adult/Adolescent (SANE-A) exam certifies registered nurses so they may treat adult and adolescent victims of sexual assault while using forensics to gather information about the incident. The exam consists of five sections or domains and has a four-hour time limit.


In order to be eligible for the exam, the IAFN requires all interested individuals to have:

  • completed an adult/adolescent sexual assault nurse examiner (SANE) nursing education comprised of at least 40 hours (in the form of coursework or contact hours)
    • OR 64 hours of an adult/adolescent/pediatric sexual assault nurse examiner education (in the form of coursework or contact hours)
  • a license as either a registered nurse or a first-level general nurse depending on where you received your license
  • two years of practice as either a registered or first-level general nurse
  • completed a supervised position as a SANE
  • At least 300 hours of SANE-related work in the last three years      

You can register for the SANE-A exam on the IAFN website, or you can fill out and submit an application if you do not have internet access.

When Should I Register for the Exam?

The SANE-A Exam is offered each year in April and September. The exam can be taken on any day of those months.

In order to reserve your place, however, you will need to register several months in advance. The deadline for the September exam is typically the first week in July while April’s exam deadline is the first week in February.

After your registration has been approved, you will receive a notification from the testing vendor, Castle/Scranton, allowing you to select a specific date and testing site for the SANE-A exam.

What is on the Exam?

Each domain on the exam is weighted differently. The percentages below indicate the amount of content per section.

Domain 1: Assessment and Documentation (32% of questions)

This section evaluates your ability to initiate care for patients brought in after a sexual assault. Topics covered include: obtaining the patient’s sexual assault and health histories, evaluating if alcohol and/or drugs were involved in the assault, and completing and recording comprehensive examination on the patient.

Domain 2: Evidence Collection (18% of questions)

As the domain’s name suggests, this section focuses on collecting forensic evidence. Topics include: how to properly preserve samples, how to identify what should be considered evidence, and the proper procedures and tools for collecting evidence.

Domain 3: Patient Management (28% of questions)

In this section, your ability to care for and interact with patients will be evaluated. Topics include: identifying necessary modes of communication (i.e. having a sign language interpreter for a deaf patient), teaching the patient about risks of pregnancy and/or sexually transmitted infections (STIs) and the testing and preventative healthcare associated with treating them, as well as preparing next steps, such as directing the patient to mental health services (i.e. counseling) and/or putting together strategies that will ensure the patient’s safety if the assailant was a significant other.

Domain 4: Legal Issues and the Judicial Process (10% of questions)

This section assesses your knowledge of the legal elements associated with a SANE. Topics include: Following any requirements associated with giving reports, as well as appearing in court on either side of the argument as a witness and giving testimony.

Domain 5: Professional Practice (12% of questions)

This section covers professionalism that must be adhered to. This includes: safety measures that must be enacted to ensure the SANE’s well-being throughout the examination, utilizing informed consent and refusal so patients make informed decisions regarding procedures, and incorporating principles such as autonomy or beneficence to ensure the welfare of the patient.

What Does the Exam Cost?

You will need to pay one of the following application fees to register.

United States

IAFN members: $275  Non-members: $425


IAFN members: $350  Non-members: $475

If you register late (during the week after the deadline), you will have to pay a fee of $150.

Do I Need to Bring Anything to the Exam?

When you arrive at the testing site, you will need to have the confirmation form (also referred to as a notice) that Castle/Scranton will send after you scheduled your exam. You will also need a form of identification with your photo and signature, such as a passport or driver’s license. 

How is the Exam Graded?

The exam uses a Pass/Fail system with a report detailing which domains to improve upon included with the score. Your results will arrive at least six weeks after you have taken the exam.

How Can I Prepare for the SANE-A Exam?

That’s a great question.  We’ve broken down the answer into three parts.

  1. Do yourself a favor and study.  Do not walk in unprepared. We have recommended prep materials below, but that only helps if you actually try.  Plus, studying is actually proven to be the best antidote to test anxiety.
  2. Take care of yourself.  Make sure you’re eating well, exercising, and sleeping.  All of these things are scientifically linked to brain performance.  If you take care of your body, you’ll be helping your grades.
  3. Get a study guide or set of flashcards.  Some people study better a certain way. Find your study strengths and make the most of them.  We’ve tried to make it easy for you by tracking down the best study guide and flashcard set for your exam. Below you’ll see links to both!

Study Guide



Last Updated: August 14, 2019