Critical Infrastructure Security Risk Assessment Questionnaire
Please complete this questionnaire to help us evaluate the security risks and resilience of your critical infrastructure assets.
Organization Name
*
Contact Person's Full Name
*
First Name
Last Name
Contact Email Address
*
example@example.com
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Facility or Asset Name/Location
*
Type of Infrastructure Asset
*
Please Select
Energy (e.g., Power Plant)
Water/Wastewater
Transportation (e.g., Rail, Airport)
Communications
Healthcare
Government Facility
Other
Identify and rate the likelihood and impact of the following risks for your asset.
*
Rows
Likelihood (1=Low, 5=High)
Impact (1=Low, 5=High)
Physical Intrusion
1
2
Cyber Attack
3
4
Natural Disaster (e.g., Flood, Earthquake)
5
6
Insider Threat
7
8
Supply Chain Disruption
9
10
Rate the effectiveness of your current security measures for the following areas.
*
Rows
Effectiveness (1=Poor, 5=Excellent)
Physical Security (e.g., Fencing, Access Control)
11
Cybersecurity (e.g., Firewalls, Monitoring)
12
Personnel Security (e.g., Background Checks)
13
Emergency Response Plans
14
Have you experienced any security incidents in the past 12 months?
*
Yes
No
If yes, please briefly describe the incident(s) and response taken.
Which of the following risk mitigation strategies are currently in place? (Select all that apply)
*
Regular Security Training
Incident Response Plan
Backup Power Systems
Access Control Systems
Cybersecurity Monitoring
Physical Barriers
Other
Please provide any additional comments, concerns, or recommendations for improving the security of your critical infrastructure asset.
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