private person test booking

Complete and submit the form below. Once you submitted the form, you will be redirected to our Payment portal. Once we received your payment, we will contact you via email and confirm your test appointment date and time.

Client Name & Surname*

Email to where we may send the test report*

Name & Surname of the person to be tested*

Select 2 alternative days of the week that will work best for the person to be tested. We will confirm our availability according to your preferred day of the week and contact you after submission of the form to confirm an appointment

Monday
Tuesday
Wednesday
Thursday
Friday

Select 2 alternative time of the day that will work best for the person to be tested. We will confirm our availability according to your preferred time and contact you after submission of the form to confirm an appointment

9am
10am
11am
2pm
3pm

Select the testing format you prefer

In person testing at our offices
Remote testing via Cellphone

If Remote Testing via Cellphone, provide cell number we can call the test taker on. If in person testing was selected, type N/A*

Describe in detail what happened (the more detail you provide, the better we can formulate the test questions and the more accurate the test will be)*

If property was stolen or damaged, please provide a list of items that was stolen/ damaged, with the exact quantities as well as the approximate replacement value in Rand. If no property was stolen or damaged, type N/A*

On what date did the incident happen? (if unknown, please type UNKNOWN)*

On what time did the incident happen? (if unknown, please type UNKNOWN)*

Attach any supporting documentation you may have here

I declare that all the information provided is the truth and I further declare that I have read the Terms & Conditions of this website and agree to it.

Yes

Biodetect Polygraph Services

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private person test Booking
Business Test Booking

+27-082 938 5989 - Leon Myburgh

info@biodetectpolygraph.co.za

12a Bloemendal Street, Rayton, Bloemfontein, South Africa