Abuse-Related Injury Photo Log
Name:
Date of Birth:
Date of Examination:
Examiner:
General Notes:
Photo 1 Description/Location of Injury:
Date Taken:
Time Taken:
Photographer:
Additional Notes:
Photo 2 Description/Location of Injury:
Date Taken:
Time Taken:
Photographer:
Additional Notes:
Photo 3 Description/Location of Injury:
Date Taken:
Time Taken:
Photographer:
Additional Notes: