The Security Incident Report Form serves as a critical documentation tool for organizations operating in the United States to record and manage security incidents in compliance with federal and state regulations. This document is essential when an organization experiences any security incident, ranging from data breaches to system compromises, and must be completed as soon as an incident is detected. The form captures vital information including incident details, affected systems, impact assessment, response actions, and regulatory notification requirements. It is designed to meet various U.S. regulatory requirements including state-specific data breach laws, federal regulations like HIPAA and GLBA, and industry-specific compliance standards. The document ensures consistent incident documentation across the organization while providing necessary information for legal compliance, insurance claims, and continuous security improvement.
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1. Incident Overview: Basic information including incident ID, date/time of discovery, reporter details, and initial incident classification
2. Incident Detection: How and when the incident was detected, including detection method and initial indicators of compromise
3. Incident Description: Detailed narrative of the security incident, including timeline of events and initial assessment of impact
4. Systems/Data Affected: Inventory of affected systems, applications, and types of data compromised or potentially compromised
5. Impact Assessment: Evaluation of the incident's impact on operations, data, and stakeholders, including severity classification
6. Response Actions: Details of immediate actions taken to contain and mitigate the incident
7. Notification Details: Documentation of all notifications made (internal and external) and planned notifications
8. Evidence Collection: List of evidence collected, including logs, screenshots, and other relevant documentation
9. Root Cause Analysis: Initial assessment of how the incident occurred and identification of vulnerabilities exploited
10. Current Status: Current state of the incident, including whether it has been contained, resolved, or is ongoing
1. Regulatory Compliance Impact: Used when incident affects regulated data or systems (e.g., HIPAA, PCI, GDPR compliance)
2. Customer Impact Analysis: Required when incident affects customer data or services
3. Financial Impact Assessment: Used for incidents with significant financial implications or potential losses
4. Law Enforcement Involvement: Include when incident requires or has involved law enforcement agencies
5. Third-Party Vendor Involvement: Used when incident involves or affects third-party vendors or service providers
6. Media Communications Plan: Include for high-profile incidents requiring public communications
7. Insurance Claims Information: Used when incident may result in cyber insurance claims
1. Appendix A - Technical Details: Detailed technical information including IP addresses, affected systems, malware details
2. Appendix B - Evidence Log: Detailed log of all evidence collected, including timestamps and chain of custody
3. Appendix C - Communication Log: Record of all communications related to the incident
4. Appendix D - Incident Timeline: Detailed chronological timeline of the incident and response actions
5. Appendix E - Affected Data Fields: Specific listing of compromised data fields and their sensitivity levels
6. Appendix F - Recovery Plan: Detailed plan for system and data recovery if required
7. Appendix G - Notification Ƶ: Ƶ for various required notifications to stakeholders
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