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Psychological History Report <br /> Anger,Problems (555-66-7779) 29-Nov-01 <br /> Has never used hallucinogens. (H28,a,96%,100%)(0) <br /> Has never used PCP or angel dust. (H32,a,100%,100%)(0) <br /> Has never used opiates. (H36,a,100%,100%)(0) <br /> Has never used amphetamines. (H40,a,97%,100%)(0) <br /> Has never used depressants(not prescribed). (H44,a,99%,100%)(0) <br /> Has never used hashish or THC. (H48,a,97%,100%)(0) <br /> Has never used other illegal drugs besides those mentioned above. (H52,a,98%,100%)(0) <br /> Has never driven after using an illegal or controlled drug. (H53,a,92%,100%)(0) <br /> Has never sold or traded drugs to others. (H54,a,99%,100%)(0) <br /> Has never provided or sold drugs to others. (H55,a,99%,100%)(0) <br /> • Was around people using illegal drugs in the last month. (H56,b,4%,3%)(3) <br /> • His current spouse, romantic partner, or roommate has used illegal or controlled drugs during the <br /> time they have lived together. (H57,c,4%,4%)(2) <br /> Has never grown or cultivated marijuana. (H58,a,99%,100%)(0) <br /> Has never been rejected from employment or military service due to alcohol or drugs. (H59,a,99%,100%)(0) <br /> Has never been disciplined or discharged from employment or military service due to alcohol or drugs. <br /> (H60,a,99%,100%)(0) <br /> General Information <br /> Completed the Psychological History Questionnaire as part of ajob application. (11,a,92%,100%)(0) <br /> Applying for the position of firefighter and/or EMT. (12,d,5%,100%)(0) <br /> Is a United States citizen. (13,a,99%,100%)(0) <br /> => Has used a surname different from the one on this application (including a maiden name). <br /> (14,b,11%,100%)(0) <br /> Has tattoos. (15,b,34%,100%)(0) <br /> Has no body piercing. (16,a,94%,100%)(0) <br /> Has no prejudices against other groups that he is aware of. (17,a,99%,100%)(0) <br /> • Has been in 3 or more physical fights since the age of 18 (other than as part of his job as a law <br /> enforcement officer). (18,d,3%,3%)(3) <br /> Has not been in any physical fights in the last 3 years(other than as part of his job as a law enforcement <br /> officer). (19,a,93%,100%)(0) <br /> Owns 1 handgun. (110,b,15%,28%)(0) <br /> Owns 1 combat or assault-type firearm. (111,b,3%,4%)(0) <br /> Did not cheat, lie, or commit fraud during the application or evaluation process for this agency. <br /> (114,a,99%,100%)(0) <br /> Has never been rejected as a job applicant because of issues raised by <br /> a medical examination. (115,a,99%,100%)(0) <br /> a background investigation. (116,a,94%,100%)(0) <br /> a psychological/psychiatric examination. (117,a,95%,100%)(0) <br /> a polygraph examination. (118,a,98%,100%)(0) <br /> a drug test. (119,a,100%,100%)(0) <br /> a physical abilities test. (120,a,95%,100%)(0) <br /> ?? Do you speak any of the following foreign languages? (Response optional) (123) <br /> =>Verify with applicant . Serious admission •,Conditional DQ admission ,• Unconditional DQ admission ??Unanswered <br /> 7/31/ffi 'LEPS PLLC PsyQ_190520 42 <br />