Confidential Polygraph Pre-Screening Questionnaire

This short self-assessment helps identify whether a polygraph examination may be appropriate before you submit an enquiry. Your answers are processed locally on your device and are not collected, stored, or viewed by the examiner.

This tool does not provide medical, psychological, or legal advice. It is designed to highlight factors that may need to be discussed before scheduling.

Primary nature of your enquiry

Solicitor / Barrister Instruction Criminal Defence / Legal Matter Family / Relationship Matter Corporate / Workplace Screening Therapeutic Disclosure Support 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

Health & Physical Considerations

Please select any of the following that currently apply to the examinee.

Selecting an item does not necessarily mean a polygraph examination cannot take place. It may simply mean the matter should be discussed before scheduling.

A cardiovascular or neurological condition diagnosed by a doctor

A respiratory condition that may affect breathing

Ongoing or significant physical pain that may affect comfort during the session

Currently pregnant or may be pregnant

Surgery or a major medical procedure within the past 6 weeks

A current illness that may be contagious (e.g. flu, COVID-19)

None of the above apply

Medication & Recent Substance Use

Please select any of the following that currently apply to the examinee.

Selecting an item does not necessarily mean a polygraph examination cannot take place. It may simply mean the matter should be discussed before scheduling.

Currently taking prescription medication

Consumed alcohol within the past 24 hours

Used non-prescribed, recreational, or controlled substances recently

Currently experiencing effects of intoxication or withdrawal

None of the above apply

Wellbeing & Emotional Readiness

Please select any of the following that currently apply to the examinee.

Selecting an item does not necessarily mean a polygraph examination cannot take place. It may simply mean the matter should be discussed before scheduling.

A current mental health condition that may affect participation

Currently receiving mental health support or treatment

Currently experiencing significant emotional distress

A history of panic attacks in formal or evaluative settings

None of the above apply

This outcome is not a medical, legal, or psychological determination. It is a preliminary indication to help guide your next steps.

Privacy Notice: Your detailed answers remain private and are processed locally on your device. They are not collected, stored, or viewed by the examiner. Only your general suitability outcome is carried forward when you continue to the enquiry form.

Continue to Confidential Enquiry