Incident Disclosure Form
Report security incidents and data breaches through a structured disclosure process. Document incidents comprehensively for regulatory notification and internal investigation.
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What is a Incident Disclosure?
An incident disclosure form provides a structured way for employees and teams to report security breaches, data incidents, and compliance violations. Timely disclosure is critical for regulatory compliance and damage mitigation.
Our template captures essential incident information: when it occurred, what type of incident, which systems and data are affected, how many people are impacted, and what initial steps have been taken. This information is crucial for incident response teams.
Many regulations (GDPR, HIPAA, CCPA, state breach laws) require notification of affected individuals within specific timeframes. A documented disclosure process ensures compliance and demonstrates good faith incident handling.
Key Features
Incident Type Classification
Categorize as data breach, security incident, compliance violation, or other
Impact Assessment
Document affected systems, data types, and number of individuals impacted
Discovery Documentation
Record how and when the incident was discovered
Mitigation Tracking
Document initial steps taken to contain and remediate the incident
Severity Classification
Rate incidents as High, Medium, or Low priority
Compliance Automation
Track disclosure timeline for regulatory notification requirements
Why Use This Template?
Regulatory Compliance
Meet mandatory incident notification timeframes required by law
Faster Response
Structured reporting ensures incidents reach incident response teams quickly
Complete Documentation
Capture all information needed for investigation and forensics
Audit Trail
Demonstrate good faith incident handling and transparent disclosure
What's Included in This Template
Incident Date & Time
datetimeEstablishes incident timeline for investigation and notification requirements
When Was Incident Discovered?
datetimeDocuments discovery time vs. incident time for response speed assessment
Incident Type
selectCategorizes the incident for appropriate response procedures
Detailed Description
textareaExplains what happened and how the incident was identified
Systems & Data Affected
textareaIdentifies which systems compromised and what data types involved
Number of Individuals Impacted
numberDetermines notification requirements and regulatory thresholds
Initial Mitigation Steps Taken
textareaDocuments containment actions already implemented
Incident Severity
selectPrioritizes incident response urgency and resource allocation
Perfect For
Data Breach Response
Report unauthorized access to personal or confidential data
Security Incidents
Document ransomware, malware, or system compromise events
Compliance Violations
Report policy violations or regulatory non-compliance
Internal Investigations
Create documented incident record for forensic analysis
Frequently Asked Questions
How quickly must we disclose incidents?
GDPR requires notification without undue delay (typically 72 hours). HIPAA requires 60 days. State laws vary. Check your specific regulatory requirements.
Who do we notify about incidents?
Affected individuals must be notified. Regulators must be notified in some cases. Depending on severity, notify law enforcement, credit bureaus, and insurance carriers.
What should we do immediately after discovering an incident?
Contain the breach (disable compromised accounts), preserve evidence, notify your incident response team, and begin investigation. Don't delete logs or evidence.
Should we hire external experts for incident response?
For significant incidents, yes. Engage cybersecurity forensics firms and legal counsel. Their involvement demonstrates good faith remediation efforts to regulators.
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