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Medical IoT Cybersecurity Assessment - SOW/Proposal
Medical IoT Cybersecurity Assessment - SOW/Proposal
Organization name
Contact Name
Title
Email
# of sites to be assessed
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1
2
3
More
# of servers
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8 or less
8-32
32-64
64+
# of end systems
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25 or less
25-50
50-250
250+
Do you have Active Directory?
-Select-
Yes
Yes, Azure Managed AD
No
Time-frame for Assessment
-Select-
with in next 3 months
with in next 6 months
with a year
Regulations organization must comply with?
HIPAA
HITECH Breach
Meaningful Use
PCI DSS
HITRUST
Other
Captcha
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Address
City
State
Zipcode
Phone
Scope of proposal?
HIPAA Assessment
HITRUST Assessment
Vulnerability Assessment
Policy Review/Update
Other
Type of organization
-Select-
Hospital
Provider
Payer
Business Associate
Other
If hospital, # of beds
-Select-
25 or less
25-50
50-250
250+
# of employees
-Select-
25 or less
25-50
50-250
250+
Estimated # of medical devices
-Select-
Less than 500
500 to 999
more than 1,000
Estimated # of IoT devices
-Select-
Less than 500
500 to 999
more than 1,000
Date of previous HIPAA assessment?
-Select-
In the last 12 months
12-18 months ago
18-24 months ago
24+ months ago
We have not done one
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