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Security Assessment Form

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SECURITY ASSESSMENT AGREEMENT AND REPORT FORM

Parties and Identification

Recitals

WHEREAS, Client desires a professional evaluation of the security posture of certain information assets and infrastructure and has engaged Assessor to perform a security assessment under the terms set forth in this Agreement; and

WHEREAS, Assessor represents that it possesses the requisite technical expertise, personnel and methodologies to perform such assessment and to prepare a report detailing findings, risk ratings and recommended remediations; and

WHEREAS, the parties intend these terms to govern the performance, delivery, confidentiality and payment related to the Security Assessment to be performed by Assessor for Client.

Scope of Work

Assessor will perform the services described below. The Scope describes the authorized techniques, deliverables and limits of the assessment. Any work outside this Scope requires a written change order signed by both parties.

Controls Evaluated

The following categories will be evaluated. Check each category included in the authorized Scope.

Findings and Risk Ratings

Assessor will document findings, assign a risk rating, and provide recommended remediation. The parties acknowledge that findings reflect conditions observed during the assessment window.

Risk Rating:

Risk Rating:

Risk Rating:

Payment Terms

Client shall pay Assessor for the Assessment services as follows. All amounts are exclusive of taxes unless otherwise stated.

Late Payment: Unpaid amounts shall accrue interest at a rate of until paid, and Client shall reimburse Assessor for collection costs and reasonable attorneys' fees.

Term and Termination

This Agreement commences on the Start Date and continues until completion of the Assessment and delivery of the final report, unless earlier terminated according to this section.

Start Date: — End Date:

Either party may terminate for convenience upon written notice to the other party provided at least days prior to the intended termination date. Termination for cause may be effected immediately upon written notice for material breach if such breach remains uncured for thirty (30) days after receipt of notice.

Confidentiality

Each party shall hold in strict confidence all Confidential Information disclosed by the other party in connection with the Assessment. Confidential Information excludes information that (a) is or becomes public other than by breach; (b) was rightfully known prior to disclosure; (c) is rightfully received from a third party without obligation of confidentiality; or (d) is independently developed. The receiving party shall use Confidential Information only to perform obligations under this Agreement and shall return or destroy such information upon termination or at discloser's request.

Governing Law and Remedies

This Agreement shall be governed by and construed in accordance with the laws designated by the parties. Any dispute arising under or relating to this Agreement shall be subject to the exclusive jurisdiction of the courts agreed by the parties and each party submits to such jurisdiction for purposes of resolving disputes.

Warranties, Liability and Entire Agreement

Assessor warrants that services will be performed in a professional and workmanlike manner consistent with industry practice. Except for this limited warranty, services are provided "as is" and Assessor disclaims all other warranties. Neither party shall be liable for incidental or consequential damages except where liability cannot be limited by law. The parties' sole remedies are those expressly provided in this Agreement.

This Agreement, including all attachments, exhibits and statements of work expressly referenced herein, constitutes the entire agreement between the parties and supersedes all prior agreements, understandings and representations regarding the Assessment.

Acceptance, Deliverables and Post-Assessment

Upon delivery of the final report, Client shall have ten (10) business days to review and provide comments. Assessor will address reasonable clarifications or corrections at no additional charge. Remediation work beyond the Scope will be subject to separate agreement and fees.

I request a follow-up review or remediation proposal.

Acknowledgement and Certifications

Client certifies that it authorizes Assessor to perform the Assessment on the assets identified and confirms that Assessor's personnel shall be provided with the access required to perform the assessment during agreed windows. Client acknowledges that intrusive testing may temporarily impact systems and that Assessor will exercise commercially reasonable care to minimize disruption.

Client authorizes the Assessment under the terms of this Agreement.

Both parties agree that the information contained in the final report is to be used for internal risk management and remediation planning. Redistribution of the report to third parties requires written consent of both parties, except as required by law.

Client Name:

By:

Date:

Assessor Name:

By:

Date:

Enter text✕

What the Security Assessment Form Is and Why It Exists

The Security Assessment Form is a standardized document used to record an organization's information security posture, control implementations, and identified risks during a formal assessment. It captures scope, asset inventory, control status, vulnerability findings, risk ratings, remediation actions, and responsible owners. Organizations use this form for internal audits, vendor assessments, compliance evidence, and pre-contract security reviews. Properly completed forms create an auditable record that supports regulatory obligations such as HIPAA and provides a single source of truth for tracking remediation and follow-up across teams.

Why Standardizing the Security Assessment Form Matters

A consistent Security Assessment Form reduces ambiguity, documents control effectiveness for audits, supports vendor due diligence, and helps prioritize remediation based on repeatable risk criteria.

Why Standardizing the Security Assessment Form Matters

Which teams typically create or request this form

Typical users who complete or request Security Assessment Forms include internal security teams, compliance officers, procurement, and third-party risk assessors.

  • Security teams and CISOs assessing internal controls and remediation progress.
  • Procurement and vendor risk teams evaluating supplier security posture during onboarding.
  • Compliance officers documenting controls for HIPAA, SOC 2, and contractual audits.

Role distribution varies by organization size: small teams combine duties, while large organizations separate responsibilities and use formal workflows.

Typical signers and approvers

CISO / Security Director

The Chief Information Security Officer or designated security director typically approves scope, validates final findings, and signs off on risk acceptance. Their approval establishes organizational accountability and supports auditability for external reviews and regulatory inquiries.

Vendor Security Manager

For third-party assessments, the vendor security manager supplies evidence, completes vendor-specific sections, and affirms control implementations. They serve as the primary contact for remediation questions and verification during contract lifecycle activities.

Essential sections every professional form should include

A complete Security Assessment Form organizes scope, assets, controls, findings, risk scoring, and remediation tasks so reviewers can reproduce results and track closure.

Scope

Define assessment boundaries, systems, networks, data types, and time frame. A precise scope prevents misunderstandings and determines which controls and assets are included for testing and review.

Asset Inventory

List hardware, software, cloud services, and data repositories in scope. Include asset owners, classification level, and business criticality to prioritize testing and remediation.

Control Inventory

Document existing administrative, technical, and physical controls mapped to standards or frameworks (for example, NIST or ISO). Note implementation status and evidence locations for each control.

Vulnerabilities

Record identified weaknesses, vulnerability sources, CVE references when applicable, impact descriptions, and supporting evidence to establish reproducibility and remediation needs.

Risk Rating

Assign likelihood and impact scores, calculate risk levels, and provide justification. Use a repeatable scoring matrix to ensure consistent prioritization across assessments.

Remediation Plan

Specify remediation tasks, responsible owners, target completion dates, compensating controls, and verification steps to confirm closure and prevent recurrence.

Core data fields to collect on the form

Organization Name: Legal entity name on record
Assessor Name: Full name and contact
Assessment Date: Enter date as MM/DD/YYYY
Scope Summary: Systems, networks, and data types
Risk Summary: Top findings with severity levels
Document Version: Version number and amendment date

Step-by-step: completing the Security Assessment Form

Follow these sequential steps to complete and finalize the form so it meets internal and external review standards.

  • 01
    Prepare Scope: Confirm systems and data in scope.
  • 02
    Collect Evidence: Gather control evidence and logs.
  • 03
    Complete Findings: Record vulnerabilities and supporting details.
  • 04
    Approve & File: Authorized signer approves and stores form.

Typical workflow from draft to archived record

This sequence shows how the form moves through creation, review, approval, and archival with an audit trail.

  • Create Form: Author uploads template and adds fields.
  • Assign Reviewers: Notify reviewers and set role order.
  • Sign & Approve: Authorized approvers sign electronically or manually.
  • Archive Record: Store signed copy with audit trail.

Key digital workflow settings to configure before sending

Configure authentication, signing order, audit level, and retention rules to match your policy before distribution.

Workflow Setting Field (name and value) Configuration
Authentication Method and Strength (email, SMS) Email link, SMS code, or KBA for high assurance
Signing Order, Reviewer Roles and Sequence Sequential or parallel by role with escalation
Audit Trail and Logging Detail Capture IP, timestamps, and action history
Retention Policy and Archive Location Auto-archive to secure storage per retention rules

Technical requirements for secure eSubmission

Confirm platform compatibility, authentication methods, and file format support before digital submission.

  • Integrations: Integrates with Salesforce and NetSuite
  • Formats Supported: PDF, DOCX, HTML, Excel
  • Authentication Options: Email, SMS, KBA, SSO

Typical internal deadlines and timeframes to include

Setting clear deadlines for review, remediation, and verification keeps findings actionable and prevents drift.

Initial Assessment Completion Date:

Enter the date assessment must be finished

Reviewer Response Deadline:

Set reviewers' response within 10 business days

Remediation Target Date:

Owners set remediation target within 30 days

Follow-up Verification Window:

Verify fixes within 60–90 days post-remediation

Annual Reassessment Schedule:

Schedule yearly reassessment or upon major change

Milestone sequence from planning through verification

These numbered stages map the major milestones of an assessment lifecycle for project planning and reporting.

01

Assessment Planning

Define scope, objectives, and schedule with stakeholders.

02

Execution & Evidence Collection

Perform tests and attach evidence to the form.

03

Reporting & Approval

Compile findings, assign risk ratings, and obtain sign-offs.

04

Remediation Verification

Confirm fixes, update status, and close findings.

Common preparation mistakes to avoid

  • Incomplete scope definitions that leave out cloud services or subcontractors, causing assessment gaps and disagreement about what was tested and what controls apply.
  • Vague or missing evidence attachments, such as screenshots without timestamps, which make it difficult for auditors to verify control implementation.
  • Unclear remediation ownership or dates, resulting in tasks not being tracked or verified and delaying closure of high-risk findings.
  • Using inconsistent risk scoring or an undocumented matrix leads to disputes over prioritization and undermines repeatability of assessments.

Principal risks and potential consequences

HIPAA Noncompliance: Civil penalties; 45 CFR §164.530(j)
Contract Breach: Liquidated damages or termination
Regulatory Audit Findings: Remediation orders and fines
Data Breach Exposure: Notification costs and penalties
Vendor Liability: Indemnity and litigation risk
Reputational Damage: Loss of business and trust

Practical examples of how organizations use the form

Real-world scenarios illustrate common uses of the Security Assessment Form across procurement and internal audit processes.

Vendor Security Assessment

A procurement team used a standardized Security Assessment Form to collect vendor control evidence before contract award.

  • Reduced review variability and disputes.
  • Standardized fields and clear evidence checklists enabled consistent scoring across vendors, accelerated procurement timelines, and produced a defensible audit trail for contract managers and internal auditors.

Internal Audit & Remediation

An internal audit group consolidated findings into a single Security Assessment Form for quarterly risk reporting to leadership.

  • Improved remediation tracking and verification.
  • Clear assignment of owners and target dates allowed the security team to measure closure rates, allocate resources to high-risk items, and demonstrate control improvements to external auditors.

Typical eSignature pricing and feature snapshot for Security Assessment Form workflows

This comparison shows starting prices and select capabilities across common eSignature providers; signNow appears first in the vendor column as the baseline for comparison.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial, no credit card required Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No envelope cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Frequently asked questions and troubleshooting tips

Answers to common questions about legal validity, signatures, notarization, retention, and supporting evidence for the Security Assessment Form.


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