Component Risk Assessment Checklist Form
Use this form to systematically evaluate and document risks associated with a specific component.
Component Name or ID
*
Component Type
*
Please Select
Hardware
Software
Service
Process
Other
Select all risk factors that apply to this component
Single point of failure
Lack of redundancy
Obsolete technology
Insufficient documentation
Security vulnerabilities
Performance bottlenecks
Other
Overall Risk Rating
*
1
2
3
4
5
Risk Likelihood and Impact Assessment
Rows
Likelihood (1-Low, 5-High)
Impact (1-Low, 5-High)
Operational Disruption
Security Breach
Data Loss
Compliance Violation
Are mitigation measures in place?
*
Yes
Partially
No
Briefly describe existing mitigation measures (if any)
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Assessor Name
*
Submit Assessment
Should be Empty: