Security Screening Image Review Form
Use this form to systematically review and assess images for security screening purposes.
Reviewer Name
*
First Name
Last Name
Date of Review
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Image Reference Number
*
Upload Image for Review
*
Upload a File
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Choose a file
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of
Image Clarity
*
1
2
3
4
5
Presence of Suspicious Items
*
No Suspicious Items
Possible Suspicious Items
Definite Suspicious Items
Type of Screening
*
Please Select
Baggage
Cargo
Personnel
Vehicle
Mail/Parcel
Other
Screening Criteria Assessment
*
Rows
Meets Requirement
Needs Further Review
Not Applicable
Prohibited Items Detected
1
2
3
Image Quality Sufficient
4
5
6
Proper Labeling/Tagging
7
8
9
Compliance with Protocol
10
11
12
Final Screening Decision
*
Cleared
Flagged for Further Review
Rejected
Reviewer Comments / Recommendations
Submit Review
Should be Empty: