Intimate partner violence screening for practices

Primary care, OB-GYN, family planning, prenatal and behavioral health practices are asked to screen patients for intimate partner violence. That work happens in the exam room, but the way a practice writes its reminders, portal messages, intake forms and web pages can help a patient speak up or can put them at risk. A text that names the topic on a shared phone, a portal message an abusive partner can read, or a page that promises to fix a dangerous situation are real hazards. This guide covers what the federal and professional sources say, how to word outreach so it stays safe, and where HIPAA allows and limits sharing.

Related topics have their own guides and are not repeated here. Pregnancy and postpartum mental health outreach is covered in our guide to perinatal depression outreach, women’s health practices in our guide to OB-GYN practice marketing, depression screening in our guide to depression screening outreach, and portal messaging in our guide to patient portal messages.

This is general information, not legal, billing or medical advice. Sources cited were checked on October 30, 2026: the USPSTF recommendation Intimate Partner Violence and Caregiver Abuse of Older or Vulnerable Adults: Screening (final statement dated June 24, 2025), the HRSA Women’s Preventive Services Guidelines page (read through an archived copy), 45 CFR 164.502(g), 164.512(c) and 164.522(b), 42 U.S.C. 300gg-13, 47 CFR 64.1200, 16 CFR 255.2 and 15 U.S.C. 45. Abuse reporting laws differ by state, and plan coverage differs by plan; check yours with a health care attorney. If someone is in immediate danger, call 911.

What the USPSTF says

The U.S. Preventive Services Task Force final recommendation on intimate partner violence and caregiver abuse of older or vulnerable adults is dated June 24, 2025. It recommends that clinicians screen for intimate partner violence in women of reproductive age, including those who are pregnant and postpartum, a B grade. It applies to adolescents and adults who are pregnant or postpartum and to women of reproductive age without recognized signs and symptoms. For caregiver abuse and neglect of older or vulnerable adults, it found the evidence insufficient to assess the balance of benefits and harms, an I statement.

The Task Force adds that the benefit depends on what happens after a positive screen: those who screen positive should be evaluated and, if appropriate, provided or referred to evidence-based interventions that include multiple components and ongoing support. It notes that interventions offering only brief counseling and information about referral options, without multicomponent support, did not show benefit in the studies it reviewed. It also found no evidence on appropriate intervals for screening.

Cite the June 24, 2025 date and the B grade in your internal notes. The Task Force page did not show an update in progress on October 30, 2026.
Build the referral path before you promote screening. A positive screen with nowhere to send the patient is not what the recommendation describes.
Do not say the USPSTF recommends screening older adults for abuse. For that group it issued an I statement, which is neither for nor against.
Do not name a screening questionnaire in marketing. The clinician picks the tool.

HRSA women’s preventive guidelines and coverage

The Women’s Preventive Services Guidelines supported by the Health Resources and Services Administration include screening and counseling for intimate partner and domestic violence. The Women’s Preventive Services Initiative recommends screening adolescent and adult women for intimate partner and domestic violence at least annually and, when needed, providing or referring to intervention services. The guideline defines the term broadly, including physical and sexual violence, stalking, psychological aggression including coercion, reproductive coercion, neglect and the threat of violence or abuse.

Under 42 U.S.C. 300gg-13, group health plans and health insurers offering group or individual coverage must cover, with no cost sharing, the preventive care and screenings for women in the guidelines supported by HRSA. Grandfathered plans are an exception, and coverage details differ by plan.

Use: “Ask your plan about coverage for preventive visits.” Avoid: “Free domestic violence screening.”
Keep screening and treatment apart. Counseling, legal help and shelter services are separate services with separate funding.
Do not quote a code, payment amount or copay on a public page.

Why safety comes before reach

The Task Force lists the barriers patients face in disclosing abuse: concern about clinician attitudes, safety and the consequences of disclosing. It says patients are more likely to disclose when they have a positive relationship with a clinician who asks directly, in private and safe settings. It also warns that virtual visits may increase the potential for harm because a partner or caregiver may overhear the answers.

For outreach, that means the person you are writing to may not be the only person who reads the message. A partner may share the phone, the email account, the portal login or the mail. Every message should be safe for that partner to see.

Keep the words abuse, violence, safety or partner out of texts, emails, lock screen previews, voicemails and envelopes.
Screen at the visit, with the patient alone for at least part of it. Do not send a violence questionnaire by text or email.
For telehealth, ask whether the patient is in a private place before any screening question, and offer to continue another way.
Do not leave a callback number that is labeled as a crisis or advocacy line in a voicemail.
Train front desk staff not to confirm appointment details to a caller who is not the patient.

Confidential contact under HIPAA

Under 45 CFR 164.522(b), a covered health care provider must let patients request, and must accommodate reasonable requests, to receive communications by alternative means or at alternative locations. The provider may ask for the request in writing and may ask for the alternative address or contact method, but may not require the patient to explain why. That is the rule that lets a patient say “do not text this number” or “send mail to a different address” without giving a reason.

Put a line on intake forms: “Tell us how and where you want us to contact you. You do not have to say why.”
Make sure your reminder and portal systems can honor a contact restriction for one patient without affecting others.
Check that billing statements and plan notices follow the same request, or tell the patient which ones you do not control.
Write down who can change a contact preference, and require the patient in person or through a verified channel.

Under 45 CFR 164.502(g)(5), a covered entity may choose not to treat a person as a patient’s personal representative if it reasonably believes the patient has been or may be subjected to domestic violence, abuse or neglect by that person, or that treating that person as the representative could endanger the patient, and, in the exercise of professional judgment, decides that doing so is not in the patient’s best interest.

Reports to authorities

Under 45 CFR 164.512(c), a covered entity may disclose information about a patient it reasonably believes to be a victim of abuse, neglect or domestic violence to a government authority authorized by law to receive such reports in three situations: when the disclosure is required by law and limited to what that law requires, when the patient agrees, or when it is expressly authorized by statute or regulation and either the provider believes it is necessary to prevent serious harm or the patient cannot agree because of incapacity and further conditions are met. Reports of child abuse or neglect fall under a separate paragraph. The provider must promptly tell the patient that a report has been or will be made, unless doing so would place the patient at risk of serious harm, or the person to be informed is a personal representative the provider reasonably believes is responsible for the abuse.

The Task Force notes that state and local reporting requirements vary, with differences in definitions, who and what must be reported and to whom, and that mandatory reporting can make patients fearful of disclosing. Patients deserve to know before they answer.

Ask a health care attorney which reports your state requires of your clinicians, and write it into a short internal policy.
Tell patients before screening, in plain words, what the practice must report and what stays between them and the clinician.
Do not write on a public page that everything a patient says is confidential if your state requires reports in some cases.

Pages and resource links

A practice page can say that clinicians ask patients about safety at home and that help is available. It should not promise to solve a dangerous situation, and it should not collect a patient’s story on a web form. Point people to resources rather than to your sales funnel.

Link the National Domestic Violence Hotline website as a resource. Link the page rather than printing a number.
Include: “If you are in immediate danger, call 911. If you are having thoughts of suicide, call or text 988.”
Do not add a contact form that asks about abuse, and do not ask for a patient’s story by email.
Do not run third party ad or analytics tags on pages about abuse, safety or crisis resources, and do not build retargeting lists from them.
Keep the topic out of URLs, page titles and email subject lines that may show up in a shared browser history or inbox.
Use no stock photos of bruised or frightened people. Plain text is safer and more respectful.

Claims and stories to leave out

Outreach on this subject should inform, not sell. Promises such as “we will keep you safe” or “leave your abuser today with our program” claim results a practice cannot back up, and a dramatic headline can do harm to someone still in the relationship.

Avoid outcome promises: “keep you safe,” “end the abuse,” “get out for good.”
Do not use a survivor’s story as an ad. Under 16 CFR 255.2(b), a consumer endorsement is likely read as what people will generally achieve, and claims must be truthful and substantiated under 15 U.S.C. 45.
Never publish a patient’s story, name or photo, even with permission, without a health care attorney’s review of the risk to the patient.
Do not frame screening as an offer, a discount or a giveaway.

Messages that stay neutral

Screening is part of a visit, so the reminder is about the visit, not the topic. These samples use placeholders; replace them with your own details.

Annual visit: “[Practice name]: It is time for your yearly visit. Call [phone] or book in the portal. Reply STOP to opt out.”
Prenatal visit: “[Practice name]: Reminder of your visit on [date] at [time]. Call [phone] to change it. Reply STOP to opt out.”
Follow-up: “[Practice name]: Please call [phone] to schedule a follow-up with [clinician name]. Reply STOP to opt out.”

Under 47 CFR 64.1200(a)(9)(iv), calls and texts to wireless numbers made by or on behalf of healthcare providers are exempt from prior express consent only when all of its conditions are met. They go only to the wireless number the patient provided, state the provider’s name and contact details, and are strictly limited to listed purposes, which include appointment and exam confirmations and reminders and wellness checkups. They contain no telemarketing, solicitation or advertising and no billing or other financial content, comply with HIPAA privacy rules, stay concise (generally 160 characters or fewer for a text), are limited to one message a day and three a week, and offer an easy opt out. Before any of these, check the patient’s contact preferences from the section above.

Illustration: two safety pages

This is an invented example to show the difference, not a real practice. Page A is titled “Domestic abuse help: get out today,” shows a stock photo of a bruised face, runs an ad pixel, asks visitors to describe their situation in a form and promises the practice will keep them safe. Page B is titled “Your visit and your safety,” says clinicians ask patients about safety at home in private, explains in plain words what the practice must report, offers to contact patients only the way they choose, links the National Domestic Violence Hotline website, lists 911 and 988, and runs no ad tags. Page A could be found by the wrong person and promises what it cannot deliver. Page B matches the sources and protects the reader.

Checklist before an IPV screening program is promoted

USPSTF wording names the June 24, 2025 date, the B grade for women of reproductive age, and the I statement for older or vulnerable adults.
A referral path to multicomponent support with ongoing contact is set up before screening is promoted.
No text, email, voicemail, envelope or preview names the topic, and no questionnaire goes out by text or email.
Intake forms ask how and where to contact the patient, and systems can honor a confidential contact request without asking why.
Your state’s reporting duties are written into policy, and patients are told before screening.
Resource links point to the hotline website, with 911 and 988 for emergencies and crisis; no ad or analytics tags on these pages.
No outcome promises, no survivor stories in ads, no stock images of injuries.
Texts meet the healthcare message conditions in 47 CFR 64.1200(a)(9)(iv).
A clinician and a health care attorney approved the page, the forms and the messages.

How we help

We build websites, local search, Google Ads, patient lead generation and AI front desk tools for independent practices and health businesses, including primary care, OB-GYN and behavioral health practices. For safety screening, that means a site that explains screening and reporting in plain words, resource pages with no ad tags, intake forms that capture contact preferences, and reminders that never name the topic. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it.

Does the USPSTF recommend intimate partner violence screening?

Yes, for women of reproductive age, including those who are pregnant and postpartum. The final statement dated June 24, 2025 gives that a B grade. For caregiver abuse of older or vulnerable adults, it found the evidence insufficient, an I statement.

What screening interval applies to intimate partner violence?

The USPSTF found no evidence on screening intervals. The Women’s Preventive Services Initiative guideline supported by HRSA recommends screening adolescent and adult women at least annually.

Can we text patients about intimate partner violence screening?

Do not name the topic in any text, email or voicemail, since a partner may see it. Send neutral visit reminders, screen in private at the visit, and honor any request to be contacted another way.

Can a patient ask us not to contact them at home or on their phone?

Yes. Under 45 CFR 164.522(b), a covered health care provider must accommodate reasonable requests to receive communications by alternative means or at alternative locations, and may not require the patient to explain why.

When can a practice report abuse to authorities under HIPAA?

45 CFR 164.512(c) permits reports to an authorized government agency when required by law, when the patient agrees, or in limited cases authorized by statute or regulation. The patient must be told promptly unless that would place them at risk of serious harm. State duties vary; ask your attorney.

Which phone numbers should our safety page list?

List 911 for immediate danger and 988 for suicidal thoughts or a mental health crisis, and link the National Domestic Violence Hotline website as a resource.

Intimate partner violence screening outreach: USPSTF 2025, HRSA women’s guidelines, safe messages, confidential contact and abuse reporting