Adverse Media Screening Log Form
Document and track adverse media screening results for compliance and risk management purposes.
Subject Name or Entity Name
*
Type of Subject
*
Please Select
Individual
Company/Organization
Other
Screening Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Country of Subject or Main Operation
Please Select
United States
United Kingdom
Canada
Australia
Germany
France
China
India
Other
Screening Keywords Used
*
Media Sources Checked (select all that apply)
*
News Websites
Social Media
Sanctions Lists
Blogs/Forums
Other
Summary of Adverse Findings
*
Risk Level Assessment
*
Low
Medium
High
Critical
Recommended Actions
*
Enhanced Due Diligence
Ongoing Monitoring
Report to Compliance
No Further Action
Other
Reviewer/Analyst Name
*
First Name
Last Name
Additional Notes or Comments
Attach Supporting Documents (e.g., screenshots, reports)
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