Employment Polygraph Protection Act

The following forms must be completed to conform with EPPA.

Holland Polygraph Services will accept no liability for providing these forms to you or for your misuse of them which might result in your violation of EPPA. Violations of the Employee Polygraph Protection Act (EPPA) carry substantial fines from the Department of Labor and open your company up to law suits which can result in substantial monitory losses. Consult with your attorney prior to your decision to use the polygraph to resolve your current problem. Consult with your attorney when you are filling out these forms. The law can change rapidly and these forms may already be outdated. Consult with your attorney prior to taking any adverse action against any of your employees and prior to making employment decisions based upon the results of a polygraph test.
EPPA Forms
Click here to download EPPA Forms
The Indemnification Agreement needs to be signed by an officer of your corporation before Holland Polygraph services will conduct a polygraph test. Your company must agree to indemnify Holland Polygraph Services from any liability arising out of your company’s use of the polygraph other than an act of negligence or willful misconduct during the actual examination on the part of Holland Polygraph Services.
The Employer’s Statement to Employee is the document that the EPPA requires that you fill out and give to EACH employee you will be asking to take a polygraph test prior to the test. We would like EACH employee to bring a copy of this document to the examination for our files. Make copies of this original document for later use. This document must be given to the employee within 72 hours of the test to allow the employee ample time to contact an attorney or union representative for advice.
Employer’s Notice of Test is written notification to Holland Polygraph Services that you have decided to test an individual employee. This separate form, accompanied by a copy of “The Employer’s Statement to Employee” which was given to the employee, should be mailed or brought to the test by each employee prior to the Examination.
Polygraph Examiner’s Notice to Examinee is supplied for your information. A copy of this form will be given to the employee during the pre-test phase.
Notice to Employee is supplied for your information. This document is read to the examinee during the pre-test phase. A completed copy of this form will be given to the employee during the pre-test phrase in our offices.
Employer’s Statement of Adverse Action is supplied for your use during the post test phase. This form is to be retained by you for your records.

For more information and to download forms, please click here.