Polygraph Consent

POLYGRAPH CONSENT

Name: _________________________________________________________



Date of Polygraph Examination: ______________________________________



I voluntarily agree to a polygraph examination on the above date.

A company representative has advised me of the following:




(1) I am guaranteed by the law the right not to take this examination as a condition of employment or continued employment.

(2) I have not been coerced in any way into either taking this test or signing this consent agreement. This act is entirely voluntary on my part.

(3) I have retained a copy of this agreement for my records.




Signature_________________________________ Date______________________