Tennessee eLAP

Form to be filled by the attending officer.

Madison County Sheriff Department
Belle Meade PD
Lexington PD
Brownsville PD
Client declined to be screened
Officer unable to screen
Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown

NEGATIVE RESPONSES TO 1-3, BUT POSITIVE RESPONSES TO 4 or MORE TO QUESTIONS 4-11 TRIGGER THE REFERRAL PROTOCOL.

Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown
Yes
No
Not answered/Unknown
Victim screened in according to the protocol
Victim screened in based on the belief of officer
Victim did not screen in
Yes
No
Yes
No
Submit

* Date Required

* Time Required

* Officer Name Required

* Case # Required

* Victim Name Required

* Police Department Required

* An officer may trigger the protocol referral.... Required

Referal Protocol Has Been Triggered