Physical games sold at retail are reviewed prior to release, with two key forms of content disclosure provided by the publisher:
- A completed questionnaire detailing any relevant content (violence, sex, language, gambling, etc.), and other factors such as context, reward systems and player control.
- A video showing typical gameplay, missions, and cutscenes, including the most "extreme" content. Unplayable content (i.e., "locked out"), if it is pertinent to a rating, must also be disclosed.
The video is reviewed by at least three trained raters, who recommend a Rating Category, Content Descriptors, and Interactive Elements. The raters' recommendation is then evaluated and confirmed, sometimes following a parity review to maintain consistency across rating assignments with similar content. A Rating Summary is then finalized, detailing the factors that led to a game's rating. Finally, the rating is issued to the publisher, which either accepts it as the final rating or chooses to revise the game's content and resubmit it, at which point the rating process starts again.
After release, testers may also play-test the game to verify that the content disclosure was complete.