Cybersecurity Incident Press Release Request Form
Submit this form to request the drafting and routing of a press release regarding a cybersecurity incident. Please provide detailed and accurate information to ensure a prompt response.
Requester Full Name
*
First Name
Last Name
Requester Email Address
*
example@example.com
Organization Name
*
Date of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Cybersecurity Incident
*
Please Select
Data Breach
Ransomware Attack
Phishing
Malware Infection
Unauthorized Access
Service Disruption (DDoS)
Other
Brief Summary of the Incident
*
Impact Assessment
*
Please Select
Minimal (No data loss, minor disruption)
Moderate (Limited data exposure, moderate disruption)
Significant (Sensitive data loss, major disruption)
Unknown
Preferred Press Release Timing
*
Immediate Release
After Internal Review
On Specific Date
Press Release Approval Contact
*
Additional Instructions or Embargo/Disclosure Notes
Submit Request
Should be Empty: