Physical and Cybersecurity Convergence Assessment Form
Use this form to assess how physical security and cybersecurity controls align, where gaps exist, and which improvements should be prioritized.
Assessment Scope
Organization Name
*
Department / Site Being Assessed
*
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Primary Contact Role / Department
*
Physical Security Controls
Access Control at Entrances
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Surveillance and Monitoring Coverage
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Current Physical Security Posture
*
Not started
Basic
Developing
Mature
Cybersecurity Controls
Identity and Access Management
*
Weak
1
2
3
4
Strong
5
1 is Weak, 5 is Strong
Network and Endpoint Protection
*
Weak
1
2
3
4
Strong
5
1 is Weak, 5 is Strong
Current Cybersecurity Posture
*
Not started
Basic
Developing
Mature
Convergence and Gaps
Cross-Functional Coordination Practices
*
Rows
Not in place
Partially in place
In place
Incident escalation between physical and cyber teams
1
2
3
Shared logs or alert visibility
4
5
6
Badge and account lifecycle alignment
7
8
9
Visitor and device access controls
10
11
12
Top Convergence Gap or Improvement Priority
Submit Assessment
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