Self-Assessment Eligibility Questionnaire

To ensure we can provide precise scheduling and appropriate evaluation protocols, please complete this preliminary self-assessment. This process is entirely confidential. Your answers are evaluated locally on your device; data is not collected, stored, or viewed by the polygraph examiner.

Primary nature of your inquiry

Legal & Criminal Defense Corporate Integrity Domestic & Family Clinical / Therapeutic Other / Unsure

Who is the examinee?

Age of the examinee

Country / Jurisdiction

Is the examinee participating voluntarily?

Yes No Unsure Prefer not to say

Does the examinee speak and understand English fluently?

Yes No Prefer not to say

Can the examinee sit still for 2–3 hours?

Yes No Prefer not to say

1. Medical & Physical Condition

Select any that apply to the examinee.

Diagnosed cardiovascular or neurological condition

Respiratory conditions affecting breathing

Currently experiencing significant physical pain

Currently pregnant or suspect pregnancy

Surgery or major procedure in the past 6 weeks

Contagious illness (e.g., flu, COVID-19)

None of these apply

2. Medication & Substance Use

Select any that apply to the examinee.

Taking prescription medications

Consumed alcohol in the past 24 hours

Used illicit or controlled substances in the past 30 days

Active intoxication or severe withdrawal symptoms

None of these apply

3. Mental & Emotional State

Select any that apply to the examinee.

Diagnosed psychiatric or psychological disorder

Currently under the care of a psychiatrist/psychologist

Experiencing severe emotional distress or acute crisis

History of panic attacks in evaluative situations

None of these apply

Privacy Notice: This pre-screening is an anonymous, self-assessment check. Your detailed answers are evaluated locally on your device and are NOT collected, stored, or viewed by the Polygraph Examiner. When you proceed to the confidential inquiry, you will only transfer your general outcome status. You will discuss any sensitive details directly with the examiner during your consultation.

Proceed to Confidential Inquiry