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Vendor Risk Assessment Request Form

Please provide the following information in order to submit a Vendor Risk Assessment (VRA) request. The request will remain pending until all information has been provided.

Required fields are marked with an asterisk

Email confirmation to(required)

Vendor Name(required)

Enter the name of the vendor to be assessed.

Vendor Risk Assessment Type(required)

Indicate whether this is the initial vendor risk assessment or a reassessment.

Business Use Case(required)

Describe the business purpose for engaging with this vendor.

Vendor Relationship Manager(required)

Enter the department, group, or individual responsible for managing the vendor relationship.

Vendor Type(required)

Select what type of products and/or services are being procured from the vendor.

Vendor Country(required)

Enter what country the vendor is located in.

Vendor Privacy Policy(required)

Enter the URL for the Vendor's Privacy Policy. Entry must begin with http.

Sensitive Data Shared(required)

Enter all sensitive data (PII, PHI, Customer Data, proprietary info, etc.) to be shared with the vendor.

Vendor Risk Tier(required)

Select the appropriate Risk Tier for this vendor

Vendor Service Duration(required)

Indicate if this vendor will be used temporarily or on an ongoing basis.

Environment for Vendor Service Deployment(required)

Indicate what environment this vendor will be used in. If your company has multiple environments (Commercial versus Federal or HIPAA), specify which environment.

SOC 2 or Third-Party Assessment Report(required)

Drag and drop files, paste screenshots, or browse

Please attach a copy of the Vendor's most recent SOC 2 Type 2, or other third-party security assessment/report or any other supporting documentation regarding the Vendor's security and privacy program.

Urgency(required)

Select the urgency of this request.

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