Lie Detector Test Pre-Exam Checklist
Read each statement carefully. After reading each statement, check the box to acknowledge you read the statement, understand the statement and consent to the statement.
Please name the Counselor, Group, Therapist or Agency that Referred You:
Please list the name(s) and relationship(s) of anyone you authorize us to share your exam details and results with.
Date of Appointment
Print Full Name:
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