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Risk Assessment Survey Template for Contingency Planning/Business Continuity Planning

OBJECTIVE

Due to HIPAA Security Rule regulations, your organization must implement Contingency Planning Practices to ensure the protection of ePHI (electronic Protected Health Information).  In order to accomplish this undertaking, there are several steps that your organization will be completing to identify critical business functions, processes, and applications that process ePHI and to understand the potential impact to the business if a disruptive event occurred.

One of the first steps of implementing the Contingency Program for your organization is to conduct a Risk Assessment (RA).  This questionnaire will help you to identify the current risks and threats to the business and implement measures to eliminate or reduce those potential risks.   Once the survey is completed, the RA Project team will analyze the data and create prioritized risk reduction (mitigation) strategies to present to senior management.

Table of Contents of Risk Assessment Template

OBJECTIVE     

GENERAL INFORMATION

  • Respondent Information
  • Company Information

PREVIOUS DISRUPTIONS       

  • Facility Related
  • Technology Related
  • Weather Related

NATURAL & MAN-MADE RISKS & THREATS    

  • Natural Risks / Threats
  • Man-Made Risks / Threats

ENVIRONMENT & FACILITY RISKS      

  • Environment Risks / Threats
  • Facility Risks / Threat

PREVENTATIVE MEASURES    

  • Hazardous Materials
  • Fire Containment
  • Emergency Notification, Evacuations, Alarms & Exits
  • Facility Features, Security,  & Access
  • HVAC
  • Utilities
  • Data Center (Technologies)

To view a specific section of this document, please contact us at Bob@training-hipaa.net or call us at (515) 865-4591.

View the Components of the Contingency Plan Templates Suite

Hospital Disaster Recovery & Business Continuity Plan Template Suite

Testimonials

FAQ on Contingency Plan Templates for Business Continuity & Disaster Recovery

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To buy individual template packages, visit following links:

Business Impact Analysis Template Packages

Risk Assessment Template Packages

Data Center Recovery Template Packages

BCP & DRP Template Packages