Personal History
PFNumber
True
Identification
Yes
Name
Name
True
Name
Separate Words
True
Name
40
Date of Birth
DateOfBirth
Date
True
BirthDate
True
DateOfBirth
10
Age at PF Creation
Age
True
Age
True
Age
Number
3
Assessment Number
AssessNumber
True
FileNumber
15
Date of Exam
DateOfExam
Separate Words
True
Date of Exam
50
Exam Location
ExamLocation
Separate Words
True
Exam Location
50
Aliases
Aliases
Separate Words
True
Aliases
36
SSN/ID
SSN
Whole Value
True
SSN
15
Scars, Marks, Tattos
Scars
Separate Words
True
Scars
50
Birthplace - City
BPCity
Whole Value
True
BirthplaceCity
20
Birthplace - State/Province
BPState
Whole Value
True
BirthplaceState
16
Birthplace - Country
BPCountry
Whole Value
True
BirthplaceCountry
20
Description
Description
3
True
Description
50
Driver License
No
Driver License #
DriversLicenseNumber
Whole Value
True
DriversLicenseNumber
16
State/Province
DriversLicenseState
True
DriversLicenseState
19
Country
DriversLicenseCountry
True
DriversLicenseCountry
19
Expiration Date
DriversLicenseExpiration
Date
True
DriversLicenseExpiration
Date
20
Demographics
Yes
Citizenship
Citizenship
Separate Words
True
Citizenship
15
Marital Status
MaritalStatus
Combobox
Single
Married
Divorced
Separated
Widowed
True
MaritalStatus
15
Education
Education
Combobox
Some High School
GED
High School Graduate
Technical School
Some College
College Graduate
Graduate Work
True
Education
20
Educational Institution
Institution
Separate Words
True
Institution
36
Dates Attended
DatesAttended
Separate Words
True
DatesAttended
40
Children:
Children
Separate Words
True
Children
50
Family/Friends in CBP?
FamilyinCBP
Yes / No
No
Yes
Separate Words
True
FamilyinCBP
15
If Yes, Explain:
ExplainFamily
Separate Words
True
ExplainFamily
50
Residence History
No
Current Address
CurrentAddress
True
Separate Words
True
CurrentAddress
20
From / To
ResDate
Separate Words
True
ResDate
25
Street
AddressStreet
Whole Value
True
AddressStreet
36
Apartment
AddressApt
Whole Value
True
AddressApt
12
City
AddressCity
Whole Value
True
AddressCity
20
State/Province
AddressState
Whole Value
True
AddressState
15
Country
AddressCountry
Whole Value
True
AddressCountry
20
Zip/Postal Code
PostalCode
Whole Value
True
PostalCode
12
Home Phone
HomePhone
Whole Value
True
HomePhone
14
Business Phone
BusinessPhone
Whole Value
True
BusinessPhone
14
Mobile Phone
Mobile
Separate Words
True
Mobile
14
Previous Address 1
PreviousAddress1
True
Separate Words
True
PreviousAddress1
15
From / To
PreviousAddressFromTo1
Separate Words
True
PreviousAddressFromTo
25
Street
PrevAddStreet1
Separate Words
True
PrevAddStreet1
25
Apartment
PrevAddApartment1
Separate Words
True
PrevAddApartment1
12
City
PrevAddCity1
Separate Words
True
PrevAddCity1
22
State/Province
PrevState1
Separate Words
True
PrevState1
12
Country
PrevAddCountry1
Separate Words
True
PrevAddCountry1
20
Zipcode
PrevAddZipcode1
Separate Words
True
PrevAddZipcode1
12
Previous Address 1
PreviousAddress11
True
Separate Words
True
PreviousAddress11
15
From / To
PreviousAddressFromTo2
Separate Words
True
PreviousAddressFromTo2
25
Street
PrevAddStreet2
Separate Words
True
PrevAddStreet2
25
Apartment
PrevAddApartment2
Separate Words
True
PrevAddApartment2
8
City
PrevAddCity2
Separate Words
True
PrevAddCity2
22
State/Province
PrevState2
Separate Words
True
PrevState2
12
Country
PrevAddCountry2
Separate Words
True
PrevAddCountry2
20
Zipcode
PrevAddZipcode2
Separate Words
True
PrevAddZipcode2
12
Comments
ResComments
Separate Words
True
ResComments
50
Family History
No
Family Member # 1
True
True
Mother's Name
MotherName
Separate Words
True
MotherName
25
Mother's Age
MotherAge
True
MotherAge
3
Mother's Occupation
MotherOccupation
True
MotherOccupation
17
Mother's Location (City, State)
MotherLocation
True
MotherLocation
24
Family Member # 2
True
True
Father's Name
FatherName
Separate Words
True
FatherName
25
Father's Age
FatherAge
True
FatherAge
3
Father's Occupation
FatherOccupation
True
FatherOccupation
17
Father's Location (City, State)
FatherLocation
True
FatherLocation
24
Family Member # 3
True
True
Spouse's Name
SpouseName
Separate Words
True
SpouseName
25
Spouse's Age
SpouseAge
True
SpouseAge
3
Spouse's Occupation
SpouseOccupation
True
SpouseOccupation
17
Spouse's Location (City, State)
SpouseLocation
True
SpouseLocation
24
Family Member # 4
True
True
Relationship
Relative1
True
Relative1
11
Name
RelativeName1
Separate Words
True
RelativeName1
25
Age
RelativeAge1
True
RelativeAge1
3
Occupation
RelativeOccupation1
True
RelativeOccupation1
17
Location (City, State
RelativeLocation1
True
RelativeLocation1
24
Family Member # 5
True
True
Relationship
Relative2
True
Relative2
11
Name
RelativeName2
Separate Words
True
RelativeName2
25
Age
RelativeAge2
True
RelativeAge2
3
Occupation
RelativeOccupation2
True
RelativeOccupation2
17
Location (City, State)
RelativeLocation2
True
RelativeLocation2
24
Family Member # 6
True
True
Relationship
Relative3
True
Relative3
11
Name
RelativeName3
Separate Words
True
RelativeName3
25
Age
RelativeAge3
True
RelativeAge3
3
Occupation
RelativeOccupation3
True
RelativeOccupation3
17
Location (City, State)
RelativeLocation3
True
RelativeLocation3
11
Family Member # 7
True
True
Relationship
Relative4
True
Relative4
11
Name
RelativeName4
Separate Words
True
RelativeName4
25
Age
RelativeAge4
True
RelativeAge4
3
Occupation
RelativeOccupation4
True
RelativeOccupation4
17
Location (City, State)
RelativeLocation4
True
RelativeLocation4
24
Family Member # 8
True
True
Relationship
Relative5
True
Relative5
11
Name
RelativeName5
Separate Words
True
RelativeName5
25
Age
RelativeAge5
True
RelativeAge5
3
Occupation
RelativeOccupation5
True
RelativeOccupation5
17
Location (City, State)
RelativeLocation5
True
RelativeLocation5
24
Comments
FamilyComments
Separate Words
True
FamilyComments
50
Military / Security Clearance
No
From / To
MilitaryHistoryFromTo
True
MilitaryHistoryFromto
20
Highest Rank
MilitaryRank
True
MilitaryRank
23
Service Branch
MilitaryBranch
Combobox
Army
Navy
Air Force
Marines
Coast Guard
True
MilitaryBranch
15
Discharge
Discharge
Separate Words
True
Discharge
32
Security Clearance From / To
SecurityFromTo
Separate Words
True
SecurityFromTo
20
Clearance Level
Clearance Level
Combobox
Top Secret/SCI
Top Secret
Secret
Separate Words
True
Clearance Level
20
Employment
No
Employment # 1
True
True
From/To
EmploymentDate1
True
EmploymentDate1
11
Employer
EmploymentEmployer1
Separate Words
True
EmploymentEmployer1
23
City, State
EmployCity1
Separate Words
True
Employ1City
30
Position
EmploymentPosition1
True
EmploymentPosition1
17
Other
EmploymentOther1
True
EmploymentOther1
15
Employment # 2
True
True
From/To
EmploymentDate2
True
EmploymentDate2
11
Employer
EmploymentEmployer2
Separate Words
True
EmploymentEmployer2
23
City, State
EmployCity2
Separate Words
True
EmployCity2
30
Position
EmploymentPosition2
True
EmploymentPosition2
17
Other
EmploymentOther2
True
EmploymentOther2
15
Employment # 3
True
True
From/To
EmploymentDate3
True
EmploymentDate3
11
Employer
EmploymentEmployer3
Separate Words
True
EmploymentEmployer3
23
City, State
EmployCity3
Separate Words
True
EmployCity3
30
Position
EmploymentPosition3
True
EmploymentPosition3
17
Other
EmploymentOther3
True
EmploymentOther3
15
Employment # 4
True
True
From/To
EmploymentDate4
True
EmploymentDate4
11
Employer
EmploymentEmployer4
Separate Words
True
EmploymentEmployer4
23
City, State
EmployCity4
Separate Words
True
EmployCity4
30
Position
EmploymentPosition4
True
EmploymentPosition4
17
Other
EmploymentOther4
True
EmploymentOther4
15
Comments
No
Comments
PersonalHistoryComments
3
True
PersonalHistoryComments
Memo
500
Medical Fitness Report
Yes
1. Do you have any medical or mental issues that make you question your ability to successfully complete the polygraph examination today?
Details
2
Separate Words
True
Explain
10
1a. If yes, Explain:
Explain
2
Separate Words
True
DrugName
50
2. Have you consumed any alcoholic beverages in the last 24 hours?
Physician
Yes / No
No
Yes
Separate Words
True
Physician
5
2a. If yes, explain:
ExplainPhys
Separate Words
True
ExplainPhys
50
3. Have you experienced any of the following?
Experienced
Separate Words
True
Experienced
5
A. Heart Problems?
Heart
Yes / No
No
Yes
Separate Words
True
Heart
5
B. High blood pressure?
BP
Yes / No
No
Yes
Separate Words
True
BP
5
C. Respiratory or lung problems?
Lung
Yes / No
No
Yes
Separate Words
True
Lung
5
D. Recent arm or leg injury?
Arm
Yes / No
No
Yes
Separate Words
True
Arm
5
E. Recent Surgery?
Surgery
Yes / No
No
Yes
Separate Words
True
Surgery
5
Explain:
Expalin
2
Separate Words
True
Expalin
50
4. Are you experiencing any physical discomfort at the present time?
Discomfort
Yes / No
No
Yes
Separate Words
True
Discomfort
5
4a. If yes, explain:
Explainpain
2
Separate Words
True
Explainpain
50
5. Have you ever practiced Yoga, Transcendental Meditation, or Bio-Feedback?
Yoga
Yes / No
No
Yes
Separate Words
True
Yoga
5
5a. If yes, explain:
5a. If yes, explain:
Separate Words
True
5a. If yes, explain:
50
6. Have you ever submitted to a polygraph examination for any reason?
PriorPoly
Yes / No
No
Yes
Separate Words
True
PriorPoly
5
6a. If yes, explain:
ExplainPoly
2
Separate Words
True
ExplainPoly
70
7. Have you ever conducted research on polygraph examinations?
PolyResearch
Yes / No
No
Yes
Separate Words
True
PolyResearch
5
7a. If yes, explain:
ExplainResearch
2
Separate Words
True
ExplainResearch
50
8. How many hours of sleep have you had in the last 24 hours?
Sleep
Separate Words
True
Sleep
15
9. When was your last meal?
LastMeal
Separate Words
True
LastMeal
50
10. In the last 24 hours, have you experienced any traumatic events?
Trauma
Yes / No
No
Yes
Separate Words
True
Trauma
5
If yes, explain:
ExplainTrauma
2
Separate Words
True
ExplainTrauma
50
11. FIT / UNFIT
FIT
Combobox
Fit
Unfit
Separate Words
True
FIT
50