Security Exception Request Form
Security Exception Request Form
Security Exception Request Form
- No tags were found...
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
UCSF SECURITY EXCEPTION REQUEST FORMInstructions:Fill out all sections in this form; sign the document; then email a scanned copy of thisform to security@ucsf.edu upon completion.<strong>Request</strong>or Contact Information:Name:<strong>Request</strong> Date:Phone Number:Email:Department:<strong>Exception</strong> <strong>Request</strong> Details:Describe your exception request.Explain the reason why you are unable to meet the UCSFʼs Minimum <strong>Security</strong> Standard.Is there any restricted information such as ePHI or PII that is part of this exceptionrequest?Describe your proposed compensating controls if granted with an exception.<strong>Request</strong>or Name<strong>Request</strong>or SignatureDept. Manager NameDept. Manager SignatureSeptember 2011 v. 1.4
ITS <strong>Security</strong> and Policy Section Only:<strong>Exception</strong> <strong>Request</strong> Answer (Approved, Denied, or Need More Information):Comments:DateISO NameISO SignatureSeptember 2011 v. 1.4
Change language