New York City has more emergency departments (ED) than any other city in the United States. Its large population and concentration of many public and private EDs present unique challenges for the provision of the best care for all sexual assault survivors. This report provides a comprehensive assessment of the acute sexual assault services available through NYC emergency departments. Chapter 1 defines the evidence base for SAFE programs and describes SAFE program components. Chapter 2 presents key findings regarding the medical care of sexual assault patients. Chapter 3 details the research findings related to forensic evidence collection and chain of evidence maintenance. Chapter 4 examines findings around advocacy, information-giving and follow-up care for sexual assault survivors. Chapter 5 explores the data around quality assurance and discusses ways to improve the acute care response. Chapter 6 concludes the report with implications of the findings for advocacy and future research. This is the second mapping of the acute sexual assault services available in NYC. The first was conducted by the Rape Treatment Consortium in partnership with the Barnard/Columbia Center for Urban Policy in 1996. The Consortium interviewed via phone and through mail surveys social workers and other hospital staff at 45 hospitals. They asked questions on eight areas: forensically trained personnel, site of exam, advocates, training, follow-up care, administration, financial support and outreach and education. This effort by the Consortium served as formative research for this comprehensive study.