AI SECURITY ASSESSMENT v2.0

AI Security Assessment

Comprehensive risk profiling for AI-enabled environments. Includes prompt injection exposure analysis and HIPAA / PHI data handling evaluation. Estimated completion: 12–15 minutes.

CONFIDENTIALHIPAA-AWAREPROMPT INJECTION RISK SCORINGNO PHI COLLECTED

Before you begin

Complete this form with the person who knows your current systems, vendors, and internal security practices best. Most teams finish in about 10-15 minutes.

Step 1

Answer each section as accurately as you can. Best estimates are fine if you do not have every detail on hand.

Step 2

Do not include patient records or other sensitive personal data. This assessment is designed to avoid collecting PHI.

Step 3

Required fields should be completed before submitting. You can move section by section and review your answers before sending.

0% complete0 / 8 sections

Organization Name*

Primary Contact Name*

Email Address*

Phone Number

Industry / Practice Type*

Number of Employees

City / State

Current Cyber Insurance?

Your responses are encrypted in transit and handled under our Privacy Policy and HIPAA BAA protocols.
A member of the Disruptivv.AI team will contact you within 1 business day to schedule your assessment.