Security Incident Report Form Please answer the questions in this form for us to better understand your security needs. This will enable the Technology & Society digital security team to customize security recommendations to strengthen your information security posture Name Email Company Product/Application Name In a few sentences, please describe the services offered by your Product Where are your users located? (Select all that apply) Africa Europe Asia North America Middle East South America Central America Oceania Caribbean In a few words, describe the security incident and how it has affected your Information system What Information system was affected by this incident? (Select all that Apply) Website Social Media Account Email Account Mobile Application Other: Other Info: What Information system was affected by this incident? (Select all that Apply) Yes No Which of the following best describes your digital security needs? (select all that apply) Compliance (Privacy) Cyber Security Access Management Security Awareness Account Recovery Other Security Needs: How often is the product being used? Not at all 1 2 3 4 5 Very Frequently How familiar are you with internet safety concepts (e.g. antivirus use, VPN, password hygiene etc.)? Not at all 1 2 3 4 5 Very Frequently What security tools do you use for your product/data? How often is the product being used? Not at all 1 2 3 4 5 Very Frequently What other privacy or digital security concerns would you need advisory on? Submit