Bratz General Hospital

Jaro, Iloilo City

PSYCHOLOGICAL EXAMINATION RESULT

Surname : Swift
Name : Taylor
Date of Birth : December 13, 1989

Examinee’s Declaration
Before you ask the doctor to sign this certificate please read the following:
1. I am aware that I will be undergoing a polygraph examination.
2. I am in good health.
3. I do not suffer from any mental health issues or other medical conditions that could
affect the polygraph examination.

I certify that to the best of my knowledge, the above statements are true.

Examinee’s signature:
Date: April 26, 2024

Doctor: Stefani Joanne Angelina Germanotta, Psy. D

I am a Psychologist

This is to state that I have examined that above named examinee for polygraph examination
and that from information available to me I can state that he/she is fit to take part in
POLYGRAPH EXAMINATION including interrogation.

Date: April 26, 2024

Doctor’s signature:
 STEFANI JOANNE ANGELINA GERMANOTTA, PSY. D.
BRATZ GENERAL HOSPITAL
Jaro, Iloilo City
PHONE: (123)456-7890 ILOILO CITY LICENSE # PSY 66666

Psychological Assessment Report

Date :4/29/2024
Examinee: Taylor Swift
DOB: December 13, 1989
Gender: Female
Ethnicity: Southeast Asian
Examiner: Stefani Joanne Angelina Germanotta, Psy. D
Testing Dates: 4/29/2024

Reason for Referral:

Ms. Taylor Swift was referred for Psychological Testing. This assessment was requested
to identify if she is fit to undergo Polygraph Examination. Types of Psychological Assessment
are the following:

 Level of Cognitive Development

 Intellectual strengths and weaknesses
 Status of Executive Functioning
 Status of Social and Emotional Functioning
 Personality Tests
 Neuropsychological Tests
 Diagnostic Measurement Tools
 Clinical Observation

Past Medical, Neurological, Psychiatric, Substance Use History:

Ms. Taylor Swift stated that she never used tobacco or recreational drugs. (No previous
Neurological or Neuropsychological Evaluations.)
Birth Developmental, Occupational History:
Ms. Taylor Swift denied any problems with her birth development. He completed High
School and College immediately. He started as a fish vendor and has earned sufficient salary
from her business.
Family History
No significant family history reported.
Psychological History and Current Adaption:
Ms. Taylor Swift is Single and a fish venodor. She stated that her hobby is
listening to music.
Current Examination:
Review of records: Clinical Interview; Cognitive Assessment; Wechsler Adult
Intelligence Scale-4(WAIS-4); Achievement Assessment: Nelson- Denny Reading
Test(Form G), Wide Range Achievement Test-4 (WRAT-4) ; Information Processing;
Lexical Fluency, Semantic Fluency, Digit Span, Ruff 2&7 Selective Attention Test, Trail
Making Test, California Verbal Learning Test-2(CVLT-2), Stroop Color Word Test,
Wisconsin Card Sorting Test; Personality Assessment: Minnesota Multiphasic
Personality Inventory-2-Restructed Form (MMPI-2-RF); Mood : Beck Depression
Inventory (BDI-2), Beck Anxiety Inventory (BAI).
Behavioral Observations:
Ms. Taylor Swift arrived on time for her appointment and was unaccompanied.
She was casually dressed, neatly groomed, and her social skills were appropriate. She
was fully cooperative throughout the evaluation. Frustration tolerance and task
persistence during tresting were preserved.
This results of this evaluation are considered reliable and valid for interpretation.
Summary of Findings:
1. Cognitive ability
Ms. Taylor Swift’s cognitive functioning is within at least the average range
based on his performance on the majority of subtests in both verbal and
non-verbal (performance) areas on the WAIS-4.
2. Achievement
Ms. Taylor Swift performed in the expected range on the other tests of
achievement including reading, writing, spelling, and sentence
comprehension.
3. Information Processing
A. Ms. Taylor Swift scores on measures of simple attention and
working memory were variable, but generally within at least the
average range. On measured of sustained attention, his
performance in the areas of speed and accuracy were consistent.
B. Language: Speech was fluent and adequately articulated, and
there was no indication of any type of impairment in auditory
communication or expressive language.
C. Visuospatial Abilities: No evidence of hemispatial neglect, object
agnosia, or other visuospatial deficits.
D. Memory: There was no evidence of a primary retentive memory
problem. She retained all the information, and her overall
performance was intact.
E. Excessive Functions: Reasoning, planning, and Response
inhibition were all generally intact.
 4. Personality and Mood
Ms. Taylor Swift completed the MMPI-2-RF and obtained a valid
profile. She is not experiencing any mental impairment.
Impression/ Recommendation
 She must find decent work to avoid negative thoughts.
 She must focus on herself to make her life better.
 Keep motivating yourself that you can do better.
 Always do your best.

Stefani Joanne Angelina Germanotta, Psy. D

Board Certified Neuropsychologist
Licensed Clinical Psychologist