(3) Provided with a written notice prior to the testing phase, in a language understood by the examinee, which shall be read to and signed by the examinee. Use of appendix A to this part, if properly completed, will constitute compliance with the contents of the notice requirement of this paragraph. If a format other than in appendix A is used, it must contain at least the following information:
- (i) Whether or not the polygraph examination area contains a two-way mirror, a camera, or other device through which the examinee may be observed;
- (ii) Whether or not any other device, such as those used in conversation or recording will be used during the examination;
- (iii) That both the examinee and the employer have the right, with the other's knowledge, to make a recording of the entire examination;
- (iv) That the examinee has the right to terminate the test at any time;
- (v) That the examinee has the right, and will be given the opportunity, to review all questions to be asked during the test;
- (vi) That the examinee may not be asked questions in a manner which degrades, or needlessly intrudes;
- (vii) That the examinee may not be asked any questions concerning religious beliefs or opinions; beliefs regarding racial matters; political beliefs or affiliations; matters relating to sexual behavior; beliefs, affiliations, opinions, or lawful activities regarding unions or labor organizations;
- (viii) That the test may not be conducted if there is sufficient written evidence by a physician that the examinee is suffering from a medical or psychological condition or undergoing treatment that might cause abnormal responses during the examination;
- (ix) That the test is not and cannot be required as a condition of employment;
- (x) That the employer may not discharge, dismiss, discipline, deny employment or promotion, or otherwise discriminate against the examinee based on the analysis of a polygraph test, or based on the examinee's refusal to take such a test, without additional evidence which would support such action;
(xi)
- (A) In connection with an ongoing investigation, that the additional evidence required for the employer to take adverse action against the examinee, including termination, may be evidence that the examinee had access to the property that is the subject of the investigation, together with evidence supporting the employer's reasonable suspicion that the examinee was involved in the incident or activity under investigation;
- (B) That any statement made by the examinee before or during the test may serve as additional supporting evidence for an adverse employment action, as described in paragraph (a)(3)(x) of this section, and that any admission of criminal conduct by the examinee may be transmitted to an appropriate government law enforcement agency;
(xii) That information acquired from a polygraph test may be disclosed by the examiner or by the employer only:
- (A) To the examinee or any other person specifically designated in writing by the examinee to receive such information;
- (B) To the employer that requested the test;
- (C) To a court, governmental agency, arbitrator, or mediator pursuant to a court order;
- (D) To a U.S. Department of Labor official when specifically designated in writing by the examinee to receive such information;
- (E) By the employer, to an appropriate governmental agency without a court order where, and only insofar as, the information disclosed is an admission of criminal conduct;
- (xiii) That if any of the examinee's rights or protections under the law are violated, the examinee has the right to file a complaint with the Wage and Hour Division of the U.S. Department of Labor, or to take action in court against the employer. Employers who violate this law are liable to the affected examinee, who may recover such legal or equitable relief as may be appropriate, including, but not limited to, employment, reinstatement, and promotion, payment of lost wages and benefits, and reasonable costs, including attorney's fees. The Secretary of Labor may also bring action to obtain compliance with the Act, and may assess civil money penalties against the employer;
- (xiv) That the examinee has the right to obtain and consult with legal counsel or other representative before each phase of the test, although the legal counsel or representative may be excluded from the room where the test is administered during the actual testing phase.
- (xv) That the employee's rights under the Act may not be waived, either voluntarily or involuntarily, by contract or otherwise, except as part of a written settlement to a pending action or complaint under the Act, agreed to and signed by the parties.