Employee Lie Detector Release

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Employee Lie Detector Release Powered By Docstoc
					Employee Lie Detector
Release
This release form can be used by a company or employer when administering a
polygraph (lie detector) examination to an employee. Polygraphs are used to determine
the accuracy and reliability of the answers given by employees. This document gives
legal consent by the employee to undergo the polygraph examination. By signing this
document, the employee voluntarily agrees to participate in the examination. The form
also provides that the results of the polygraph test can only be released to certain
individuals or organizations and can limit the topics covered in the examination. This
form should be used by an employer whenever administering a polygraph examination
to an employee..
                                POLYGRAPH CONSENT
TO:                                            [NAME OF PERSON,
BUSINESS, ETC. WHO WILL BE GETTING PERMISSION TO VIEW AND USE THE
POLYGRAPH RESULTS]

FROM:                                       [NAME OF PERSON--OR
AGENT OF PERSON--WHO WILL BE AGREEING TO UNDERGO THE
POLYGRAPH EXAM]

       RE:            Consent to Polygraph Test

       THE UNDERSIGNED hereby consents to __________________ [NAME OF
PERSON OR AGENCY OR COMPANY WHO WILL BE DOING THE EXAM]
performing a polygraph test on the undersigned. The polygraph test shall be held at
___________________ [LOCATION OF TEST] at ________ a.m./p.m. on the _____ day of
___________, 201_____.

        THE UNDERSIGNED, hereby further consents __________________ [NAME OF
PARTY WHO WILL BE DOING THE POLYGRAPH] to release the results of the
undersigned’s polygraph test to the following organizations/individuals only and the said results
shall not be used by the recipient(s) for any unlawful purpose:

       (i)     __________________________________;

       (ii)    __________________________________; and

       (iii)   __________________________________.

       THE UNDERSIGNED consents to a polygraph exam that relates ONLY to the
following subject(s), topic(s), issue(s), and/or incident(s).

       (a)     ___________________________________

        (b)    ___________________________________
{Instruction: Specify what the polygraph will cover. Parties can also specify topics or issues
that the polygraph will NOT cover. Add additional lines, if necessary.}

        THE UNDERSIGNED, acknowledges that he/she is taking the said polygraph test of
his/her own free will and without duress or being coerced

       DATED this ____ day of ___________________, 201_____.


Witness:                                     Signature


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DOCUMENT INFO
Description: This Polygraph Consent form can be used by a company or employer when administering a polygraph examination to an employee. Polygraphs are used to determine the accuracy and reliability of the answers given by employees. This document gives legal consent by the employee to undergo the polygraph examination. By signing this document, the employee voluntarily agrees to participate in the examination. The form also provides that the results of the polygraph test can only be released to certain individuals or organizations and can limit the topics covered in the examination. This form should be used by an employer whenever administering a polygraph examination to an employee..
This document is also part of a package HR Forms for your Business 108 Documents Included