Risk Assessment Likelihood Rating Survey Form
Please complete this Risk Assessment Likelihood Rating Survey Form to help us evaluate and prioritize potential risks. Select the most accurate options for each question.
Select the risk category you are assessing
*
Please Select
Operational Risk
Strategic Risk
Compliance Risk
Financial Risk
Reputational Risk
Other
Rate the likelihood of this risk occurring
*
1
2
3
4
5
Rate the potential impact if this risk occurs
*
1
2
3
4
5
How well are current controls mitigating this risk?
*
Very Well
Adequately
Somewhat
Poorly
Likelihood and Impact Matrix
*
Rows
Likelihood
Impact
Risk Scenario 1
1
2
Risk Scenario 2
3
4
Risk Scenario 3
5
6
What is the timeframe in which this risk could materialize?
Immediate (within 3 months)
Short-term (3-12 months)
Medium-term (1-3 years)
Long-term (over 3 years)
How confident are you in your assessment?
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Select your department or role
Please Select
Operations
Finance
Compliance
IT
Executive
Other
Please provide any additional comments or context for your assessment
Date of assessment
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Assessment
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