VAIDIK, J.
Dennis Perry appeals his convictions for strangulation, criminal mischief, and possession of cocaine. Perry was accused of assaulting his ex-girlfriend, N.D. After the alleged assault, N.D. sought assistance from police and was brought to the hospital for examination. She told her examining nurse that she had been sexually assaulted and strangled. She further identified Perry as the assailant. N.D.’s statements were admitted at trial via a medical record prepared by the examining nurse. N.D. did not testify. Perry argues that N.D.’s statements constituted inadmissible hearsay and that their admission violated his Sixth Amendment right to confrontation. We conclude that N.D.’s material statements—those detailing her physical attack and identifying her attacker—were admissible pursuant to the medical diagnosis exception to the hearsay rule. We further conclude that N.D.’s statements were nontestimonial under Crawford v. Washington, 541 U.S. 36 (2004), and Davis v. Washington, 547 U.S. 813 (2006), and thus did not implicate Perry’s confrontation rights.
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Nurse Calow completed a medical record in connection with her examination of N.D. State’s Ex. 6A. The report identified “Dennis [P]erry” as the suspected assailant. Id. It relayed N.D.’s statements that Perry “grabbed her around the neck” and that N.D. experienced pain from an “attempted strangulation.” Id. . . . .
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During Nurse Calow’s testimony, the State offered the medical record into evidence. Perry objected, arguing that N.D.’s statements within the record constituted inadmissible hearsay. Perry did not raise an objection on Sixth Amendment grounds.
The trial court admitted the record over objection, though the narrative portion was redacted to read as follows:
Mr. [P]erry then ordered her to drive him to a friend’s house. Pt states she is afraid of Mr. [P]erry so she did as he asked because she didn’t want to get hurt. He then ordered her to drive. Mr. [P]erry said “I want to fuck”. Pt said no due to her being on her period now. Mr. [P]erry then grabbed her by the waist and pulled her on top of him. He then ordered her to take out her tampon. [H]e was about to “nut” and pulled her on top of him so that his penis was inside her. She then stated he was inside for about 10 seconds when he ejaculated in her. He reached over and started strangling her with his hands. He got in the drivers seat and reached over to strangle her some more. Mr. [P]erry then drove to a gas station to get some cigarettes while [N.D.] laid in the back seat of the car. He then drove them back[.] That is when the assailant noticed his colostomy bag had ruptured and he got out of the car. [] Mr. [P]erry came at her with a tire iron. He tried to break the drivers side window, shattered the windshield. [N.D.] then drove off and went to the nearest police station.
State’s Ex. 6.
Perry argues that the trial court erred by admitting Nurse Calow’s medical record and N.D.‟s statements relayed therein. Perry maintains that (A) the statements constituted inadmissible hearsay and (B) their admission violated his right to confrontation under the Sixth Amendment.
A. Hearsay Claim
The first issue is whether the medical record and N.D.‟s statements within constituted inadmissible hearsay under the rules of evidence.
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This case involves multiple hearsay under Rule 805—that is, N.D. made several out-of-court statements to Nurse Calow, and Nurse Calow prepared an out-of-court medical record relaying what N.D. told her. Both N.D.’s statements and Nurse Calow’s record were offered at trial for their truth. Accordingly, we analyze each set of statements in turn to determine their admissibility under an applicable hearsay exception.
1. Statements by N.D. to Nurse Calow
We first address the admissibility of N.D.’s out-of-court statements to Nurse Calow.
Indiana Evidence Rule 803(4) sets forth the “medical diagnosis exception” to the hearsay rule. Rule 803(4) provides for the admissibility of statements “made for purposes of medical diagnosis or treatment and describing medical history, or past or present symptoms, pain, or sensations, or the inception or general character of the cause or external source thereof insofar as reasonably pertinent to diagnosis or treatment.” The rationale underlying the exception is that a declarant’s self-interest in seeking treatment reduces the likelihood that she will fabricate information that she provides to those who treat her. McClain v. State, 675 N.E.2d 329, 331 (Ind. 1996).
In determining the admissibility of hearsay under Rule 803(4), courts evaluate (1) whether the declarant’s motive was to provide truthful information to promote diagnosis and treatment and (2) whether the content of the statement is such that an expert in the field would reasonably rely on it in rendering diagnosis or treatment. In re Paternity of H.R.M., 864 N.E.2d 442, 446 (Ind. Ct. App. 2007).
Statements attributing fault or establishing a perpetrator’s identity are typically inadmissible under the medical diagnosis exception, as identification of the person responsible for the declarant’s condition or injury is often irrelevant to diagnosis and treatment. Beverly v. State, 801 N.E.2d 1254, 1259 (Ind. Ct. App. 2004), trans. denied.
However, we have noted that in cases involving child abuse, sexual assault, and/or domestic violence, courts may exercise their discretion in admitting medical diagnosis statements which relay the identity of the perpetrator. See Nash v. State, 754 N.E.2d 1021, 1024-25 (Ind. Ct. App. 2001); see also Dowell v. State, 865 N.E.2d 1059 (Ind. Ct. App. 2007), summarily aff’d in relevant part, 873 N.E.2d 59 (Ind. 2007). As we recognized in Nash:
All victims of domestic sexual abuse suffer emotional and psychological injuries, the exact nature and extent of which depend on the identity of the abuser. The physician generally must know who the abuser was in order to render proper treatment because the physician’s treatment will necessarily differ when the abuser is a member of the victim’s family or household. In the domestic sexual abuse case, for example, the treating physician may recommend special therapy or counseling and instruct the victim to remove herself from the dangerous environment by leaving the home and seeking shelter elsewhere. In short, the domestic sexual abuser’s identity is admissible under Rule 803(4) where the abuser has such an intimate relationship with the victim that the abuser’s identity becomes “reasonably pertinent” to the victim’s proper treatment. 11
754 N.E.2d at 1024-25 (quoting United States v. Joe, 8 F.3d 1488, 1494-95 (10th Cir. 1993)).
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Here we conclude that the material statements N.D. made to Nurse Calow—namely, those describing the physical attack and identifying Perry as the assailant—were admissible pursuant to Rule 803(4). N.D.’s statements indicating she was “grabbed . . . around the neck” and strangled were pertinent to the diagnosis and treatment of her physical injuries. And N.D.’s identification of her assailant was pertinent to potential treatment for HIV or other sexually transmitted diseases, relevant to any psychological counseling for domestic abuse, and significant to medical personnel in deciding how to discharge their patient. As Nurse Calow explained, “When we meet with them we‟re assessing the patient at first, her demeanor, any — I need to know her state of mind. Any medical history . . . if she knows the assailant‟s medical history too it‟s important. That guides me, the treatment plan that I‟m going to do. Where I need to look for injuries. I get the history of the assault too . . . .” We acknowledge that additional statements in the medical record may have exceeded the scope of the medical diagnosis exception and were left unredacted. For example, N.D. said that Perry “ordered her to drive him to a friend’s house” and “drove to a gas station to get some cigarettes.” We conclude, however, that any error in the admission of these nonmaterial statements was harmless. . . . .
2. Record Prepared by Nurse Calow
The next question concerns the admissibility of the medical record itself.
Indiana Evidence Rule 803(6) sets forth the hearsay exception for “records of regularly conducted business activity.” . . . .
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To be sure, the hearsay rules exclude “investigative reports by police and other law enforcement personnel” when offered against the accused in criminal cases. See Ind. Evidence Rule 803(8). . . . .
However, we do not read “police and law enforcement personnel” to encompass treating physicians or nurses, even where such medical personnel may act in cooperation with law enforcement authorities. Cf. Nash, 754 N.E.2d at 1026 (record from nurse’s examination of victim held admissible); 30B Michael H. Graham, Federal Practice & Procedure § 7047 (Interim ed. 2006) (noting that ambulance driver’s report would be admissible on its face); United States v. Rosa, 11 F.3d 315, 331-33 (2d Cir. 1993) (medical examiner not “law enforcement personnel” under 803(8)).
We conclude that N.D.’s medical record and Nurse Calow’s observations relayed therein were admissible pursuant to Rule 803(6). Nurse Calow created the record in connection with her contemporaneous evaluation of N.D. and in the course of the hospital’s regular business activity of consulting patients and documenting treatment. We therefore find no error in its admission.
B. Confrontation Claim
Perry next argues that the admission of N.D.’s statements violated his Sixth Amendment right to confrontation. . . . .
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In Crawford v. Washington, the United States Supreme Court reexamined the history surrounding the Confrontation Clause and concluded that, even where hearsay is deemed admissible under the rules of evidence, if the hearsay is “testimonial” in nature, then the Sixth Amendment bars its admission in criminal trials unless the declarant is unavailable to testify and the defendant had a prior opportunity for cross-examination. 541 U.S. 36, 68 (2004).
Our analysis of multiple hearsay under Crawford proceeds in a stepwise fashion as under the rules of evidence. Or in the words of one court, “the Confrontation Clause principle enunciated in Crawford is implicated only if one or more levels of multilevel hearsay involve both a testimonial statement and the unavailability of—and lack of prior opportunity to cross-examine—the declarant of that statement. . . . Stated another way, in order for Crawford to apply to a multilevel hearsay statement, the two prerequisites to that application—a testimonial statement and an unavailable declarant—must coincide on at least one level.” State v. Ennis, 158 P.3d 510, 518 (Or. Ct. App. 2007).
1. Statements by N.D. to Nurse Calow
We must determine whether the admission of N.D.’ statements to Nurse Calow violated Perry’s confrontation rights—or more specifically, whether N.D.’s statements constituted “testimonial” hearsay which, in the absence of any opportunity to cross-examine N.D., were inadmissible under Crawford and the Sixth Amendment.
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So in assessing whether N.D.’s statements to Nurse Calow were “testimonial” for purposes of the Sixth Amendment, the question is: what, objectively speaking, was the primary purpose of Nurse Calow’s examination and N.D.’s statements incident thereto?
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In line with the foregoing, we conclude that N.D.’s statements to Nurse Calow describing her physical attack and identifying her assailant were nontestimonial. N.D. was allegedly the victim of an unprotected sexual assault. The assault resulted in physical injuries to N.D.’s neck, ears, and back. N.D. was transported to the hospital shortly thereafter to receive medical attention and psychological assessment. She was tested for pregnancy and STDs and was given medication to reduce the risk of gonorrhea, chlamydia, and other infections. N.D. had already recounted the events in question to law enforcement before going to the hospital. And significantly, Nurse Calow described her protocol in pertinent part: “When we meet with them we’re assessing the patient at first, her demeanor, any — I need to know her state of mind. Any medical history . . . if she knows the assailant’s medical history too it’s important. That guides me, the treatment plan that I’m going to do.” (Emphasis added). We believe that the totality of the circumstances, viewed objectively, indicates that the primary purpose of Nurse Calow’s examination and the primary purpose of N.D.’s statements in the course thereof were to furnish and receive emergency medical and psychological care. We recognize that the examination had an investigative component. Nurse Calow was a forensic nurse. She took pictures of N.D.’s injuries and collected DNA samples to send to analysts. N.D. signed consent forms permitting any evidence obtained during the exam, as well as the medical record itself, to be forwarded to law enforcement. We further acknowledge that N.D. was transported to the hospital by police, though we note that no officers were present during Nurse Calow’s intake interview or examination. At any rate, evaluating the encounter objectively and in light of all relevant factors, we still cannot say that the “primary purpose” of the exam from either the patient’s or caretaker’s perspective was to prove past facts with an eye toward trial. To echo the Ohio Supreme Court, that function was at best secondary to the principal objective of providing and receiving medical attention. We therefore conclude that N.D.’s statements were nontestimonial under Crawford, Davis, and Bryant and did not implicate Perry‟s Sixth Amendment right to confrontation.
2. Record Prepared by Nurse Calow
The remaining question concerns the admissibility under Crawford of the medical record itself.
Crawford made clear that “when the declarant appears for cross-examination at trial, the Confrontation Clause places no constraints at all on the use of his prior testimonial statements.” 541 U.S. at 59 n.9.
Nurse Calow was the technical “declarant” of the overall medical record. She appeared at trial and was subject to cross-examination by the defense. So assuming that the medical record itself was a testimonial document under Crawford, the Sixth Amendment posed no bar to the admission of the record on its face.
For the reasons stated, we conclude that the admission of N.D.’s medical record and statements relayed therein did not run afoul of Perry’s Sixth Amendment rights.
KIRSCH, J., and MATHIAS, J., concur.