Breach Risk Assessment Questionnaire
Use this questionnaire to assess your organization’s breach risk posture. Please answer based on current practices and controls.
Respondent and Organization Details
Respondent Name
*
Job Title or Role
*
Organization/Company Name
*
Primary Work Email
*
example@example.com
Environment and Scope
Industry or Business Type
*
Please Select
Healthcare
Financial Services
Technology
Retail
Manufacturing
Education
Professional Services
Government
Nonprofit
Other
Approximate Employee Count
*
Please Select
1–10
11–50
51–200
201–500
501–1,000
1,001–5,000
5,001+
Assessment Scope by Location
*
One location
Multiple locations
Access, Controls, and Exposure
Current Security Posture Assessment
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Access controls are appropriately restricted and reviewed
1
2
3
4
5
Multi-factor authentication is in use for critical systems
6
7
8
9
10
Employees receive regular security awareness training
11
12
13
14
15
Systems and applications are patched on a timely schedule
16
17
18
19
20
Devices are centrally managed and protected
21
22
23
24
25
Backups are current and recovery has been tested
26
27
28
29
30
An incident response plan is documented and ready
31
32
33
34
35
Do any third-party services handle sensitive business data?
*
Please Select
Yes
No
Unsure
Additional details or exceptions
Submit
Should be Empty: