Attorney/Client Polygraph Request

When submitting a request for a Polygraph Examination, the Attorney is requested to provide all information surrounding the issue they wish to have the individual tested for.

This agency conducts “specific issue” examinations. We do not mix issues, so as to ensure the validity of the results.  By testing for “One issue at a time”, it assures that the examination’s target issue is not clouded by a laundry list of conflicting or redundant subjects. In addition, this method ensures that truth or deception of the responses are confined to the “specific issue” and no other factors are involved.

Examinee must supply Photo ID at the time of Examination.


Case Information requested to accompany the Attorney Request:

  • Will the attorney be present during all phases of the examination?
  • Case Number (if applicable)
  • Specific Issue to be tested for (Allegation) - NOTE: Multiple Issues will require Multiple Examinations
  • Full Legal Name of Examinee (if female, also require Maiden Name and ALL married names)
  • Copies of all Police Reports and other documentation (i.e. court records), if available and pertinent
  • Synopsis of case information the examinee has specifically told his/her lawyer
  • List of all medications and the prescribed dosage currently taken by the examinee
  • Time frame / restrictions for the examination

Optional Information provided by the Attorney:

  • History of any drug addiction/usage, if applicable to the examination issue.
  • If pertinent to the attorney, they may wish to consider a urinalysis 8 - 24 hours prior to the examination.
  • Would recommend that payment be made through the attorney’s firm, therefore all information becomes their work product.
  • Does the attorney wish to have the examination video taped, from start to finish?

Attorney Polygraph Request Form






Please use the Examinee’s Full Legal Name, including suffixes

*  Required

Clugston Polygraph and Investigative Services




Grove Office Location:
221 E 3rd St.
Grove, Oklahoma 74344

Mailing Address:
P.O. Box 452409
Grove, Oklahoma 74345-2409

Tulsa Office Location:
320 S Boston Ave.
Ste. 1130
Tulsa, Oklahoma 74103

Phone: 918-622-7008


e-mail: roy@clugston-investigations.com

Serving Northeast Oklahoma, as well as Tulsa and Oklahoma City





We comply fully with the Gramm-Leach-Bliley Act of 1999





Copyright 2008 - 2015 Clugston Polygraph & Investigative Services

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