Release FormPsychological Evaluation
The Witness Security Reform Act of 1984 requires a psychological
evaluation of each individual (over 18 years old) who is being considered
inclusion in the Witness Security Program.|
The suitability of an individual for the Program must be determined
OEO before that person may be accepted into the Program. One of the factors
must be considered in determining the suitability of an individual for
into the Program is the report of the psychological evaluation.
After an individual has been psychologically evaluated, the
authority will prepare and submit a report to the Office of Enforcement
Operations, Criminal Division, Department of Justice, so that a
be made as to the suitability of the witness for the Program.
The following is the release form, referred to in USAM 9-21.330, that each individual being
psychologically evaluated is required to sign, prior to the evaluation:
I, _______________, certify that I have read and understand the
foregoing and that I voluntarily submit to this psychological evaluation. I
understand that my acceptance or rejection for placement in the Witness
Program is not solely dependent upon the results of this psychological
I also certify that I have no objection if the contents of the
of my psychological evaluation are disclosed to others in connection with my
consideration for the Program or other lawful use.
(Witness or adult family member)
[cited in USAM 9-21.330]