Risk Reporting Form

For purposes of this form, RISK is defined as the potential that a given action or issue might purposely or inadvertently cause harm to a person, place, device, or network.

Examples of Risks:

  • Users on unassigned workstations
  • Propping open security doors
  • “Piggy-backing” or tailgating through a secured door without use of a badge
  • Damaged or broken wires/cables
  • Malfunctioning badge scanners
  • Locks or latches that do not fully close
  • Inattention to securing confidential information
  • Unlocked/unattended computers
  • Inappropriate material being viewed on State devices
  • Disgruntled employees
  • Many others!
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    Contact information is optional; however, the ability to gather more information is very useful to those investigating the reported risks. Please let us know if we can use you as a contact or reference as we work to resolve the issue.  

    If you do not wish to leave your name, please provide one or more persons with whom we can follow-up on this risk.

    Your Name:

    May we use as a contact?
    Other Contact:

    Phone:

    Email Address:

    Department/Agency:

    Description of Risk or Vulnerability: *

    Attachments

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    Last Updated: 05/07/2013