DA FORM 2801 Fillable – Army Pubs 2801 PDF

DAFORMFILLABLE.COM | DA FORM 2801 Fillable – Army Pubs 2801 PDF – When it comes to conducting polygraph examinations within the U.S. Army, the DA FORM 2801 plays a critical role. Officially titled the Polygraph Examination Statement of Consent, this form is an essential document for legal and procedural compliance in the administration of lie detection tests. This article provides a comprehensive overview of DA FORM 2801, helping individuals understand its purpose, usage, and significance in military procedures.

DA FORM 2801 – Polygraph Examination Statement Of Consent

Form Number DA Form 2801
Form Title Polygraph Examination Statement Of Consent
Form Date 06/01/2011
Form Proponent CID

What is DA FORM 2801?

DA FORM 2801, or the Polygraph Examination Statement of Consent, is a standardized document used by the Criminal Investigation Command (CID) of the U.S. Army. The form was first introduced on June 1, 2011, and remains active as a vital component in the polygraph examination process. It is designed to obtain the consent of individuals undergoing a polygraph test, ensuring that they are fully aware of the nature and implications of the procedure.

Purpose of the Form

The primary purpose of DA FORM 2801 is to secure informed consent from individuals before they undergo a polygraph test. This form ensures that the examinee understands their rights, the voluntary nature of the examination, and the potential uses of the information derived from the test. By signing the form, the examinee agrees to the terms and conditions under which the polygraph test is administered.

The form adheres to the guidelines specified in AR 195-6, which outlines the procedures for the use of polygraph testing within the Army. It serves as a legal document that protects both the rights of the individual and the integrity of the examination process. Ensuring that the form is properly filled out and signed is crucial for maintaining transparency and accountability in the use of polygraph examinations.

Key Components of DA FORM 2801

DA FORM 2801 includes several important sections that need to be thoroughly understood by both the examiner and the examinee:

  • Consent Section: This is where the examinee acknowledges that they have been informed about the test and consent to undergo the polygraph examination voluntarily.
  • Rights Advisory: The form provides a clear statement of the examinee’s rights, including the right to consult with legal counsel prior to signing the form.
  • Use of Information: It outlines how the information from the polygraph can be used, ensuring that the examinee is aware of the potential implications.

Accessibility and Distribution

The form is marked with a Distribution Restriction Code A, indicating that it is approved for public release and its distribution is unlimited. This accessibility ensures that all relevant personnel can easily obtain and utilize the form as needed.


DA FORM 2801 is a fundamental document for conducting polygraph tests within the U.S. Army, ensuring that all parties involved understand and agree to the terms of the examination. It upholds the principles of voluntary participation and informed consent, which are crucial for the ethical and legal administration of polygraph testing. For individuals and professionals dealing with military procedures, being familiar with the use and significance of this form is essential for maintaining compliance and transparency in polygraph examinations.

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