Privacy, Compliance & Data Ethics — Impact Assessment Template

{"Title":"Privacy & Ethics Impact Assessment","IntroductionHtml":"

Use this assessment to identify, evaluate, and document privacy, compliance, and ethical risks for any project, model, or dataset that uses personal data or produces automated decisions. Complete fields honestly, attach evidence where appropriate, and record approvals. Saving the form stores a submission you can review later.

","SubmitLabel":"Save Assessment","SuccessMessage":"Assessment saved. Return to edit or create a new assessment anytime.","DataType":"PrivacyImpactAssessment","SchemaVersion":"1.0","Fields":[{"Key":"project_name","FieldType":"text","Label":"Project / Model Name","HelpText":"Short, descriptive name for the project or model.","Required":true},{"Key":"project_owner","FieldType":"text","Label":"Project Owner / Responsible Person","HelpText":"Name and role of the person accountable for privacy decisions.","Required":true},{"Key":"project_description","FieldType":"textarea","Label":"Project Description and Use Case","HelpText":"Describe what the project does, what decisions will be made, who benefits, and who may be affected.","Required":true},{"Key":"data_inventory_summary","FieldType":"textarea","Label":"Data Inventory and Sensitivity","HelpText":"List data types used (PII, PHI, device IDs, location, behavioral, inferred attributes). Note sensitivity (low/medium/high) and any third-party sources.","Required":true},{"Key":"data_retention","FieldType":"text","Label":"Planned Data Retention Period","HelpText":"How long will data be stored, and why? Include criteria for deletion or anonymization.","Required":false},{"Key":"data_sharing","FieldType":"checkbox","Label":"Data Sharing and Transfers","HelpText":"Check any that apply.","Options":[{"Value":"internal_team","Label":"Shared internally (teams)"},{"Value":"external_partners","Label":"Shared with external partners"},{"Value":"cloud_provider","Label":"Stored/processed by cloud provider"},{"Value":"cross_border","Label":"Cross-border transfer"}],"Required":false},{"Key":"lawful_basis","FieldType":"select","Label":"Lawful Basis / Legal Justification","HelpText":"Choose the lawful basis for processing personal data (adjust options to local law).","Options":[{"Value":"consent","Label":"Consent"},{"Value":"contract","Label":"Contractual necessity"},{"Value":"legal_obligation","Label":"Legal obligation"},{"Value":"vital_interests","Label":"Vital interests"},{"Value":"public_task","Label":"Public task"},{"Value":"legitimate_interests","Label":"Legitimate interests"},{"Value":"other","Label":"Other — explain"}],"Required":true},{"Key":"purpose_mapping","FieldType":"textarea","Label":"Purpose and Use-Case Mapping","HelpText":"Describe each intended use of the data and map it to the legal basis, teams, and downstream consumers.","Required":true},{"Key":"automated_decisions","FieldType":"yesno","Label":"Does the project generate automated or consequential decisions?","HelpText":"Examples: automated approvals/denials, scoring, recommendations that materially affect people.","Required":true},{"Key":"human_review","FieldType":"select","Label":"Human-in-the-loop Controls","HelpText":"If automated decisions occur, how will humans review or override outputs?","Options":[{"Value":"none","Label":"None"},{"Value":"spot_check","Label":"Spot checks / sampling"},{"Value":"manual_review_high_risk","Label":"Manual review for high-risk cases"},{"Value":"appeals_process","Label":"Formal appeals process"}],"Required":false},{"Key":"reid_risk","FieldType":"scale","Label":"Risk of Re-identification","HelpText":"Estimate how likely it is that individuals could be re-identified from the data (0=none, 5=very high). Consider direct identifiers, quasi-identifiers, and linkage risk.","Scale":{"Min":0,"Max":5},"Required":true},{"Key":"bias_risk","FieldType":"scale","Label":"Risk of Bias or Unfair Outcomes","HelpText":"Estimate the likelihood that model or process will produce biased or discriminatory outcomes (0=none, 5=very high). Consider training data, representation, and outcome disparities.","Scale":{"Min":0,"Max":5},"Required":true},{"Key":"downstream_misuse_risk","FieldType":"scale","Label":"Risk of Downstream Misuse","HelpText":"Could legitimate outputs be misused later (profiling, surveillance, discriminatory operations)? (0=none, 5=very high)","Scale":{"Min":0,"Max":5},"Required":true},{"Key":"overall_risk_score","FieldType":"number","Label":"Calculated Overall Risk Score","HelpText":"Automators may calculate this client-side as a sum or weighted average. If left blank, approvers may compute during review.","Required":false},{"Key":"mitigations","FieldType":"textarea","Label":"Proposed Mitigations and Controls","HelpText":"List technical, organizational, and procedural mitigations (anonymization, minimization, encryption, access controls, bias mitigation, monitoring). Be specific and assign owners and deadlines.","Required":true},{"Key":"anonymization_approach","FieldType":"select","Label":"Anonymization / Pseudonymization Approach","HelpText":"Choose the approach and reference any verified methods or tests.","Options":[{"Value":"none","Label":"None"},{"Value":"pseudonymization","Label":"Pseudonymization (reversible)"},{"Value":"anonymization_statistical","Label":"Statistical anonymization (tested)"},{"Value":"synthetic_data","Label":"Synthetic data (explain method)"},{"Value":"other","Label":"Other — explain"}],"Required":false},{"Key":"acceptance_criteria","FieldType":"textarea","Label":"Acceptance Criteria for Deployment","HelpText":"Define measurable criteria that must be met before deployment (e.g., re-id risk <=2, fairness metric parity within X%). Include monitoring triggers and rollback conditions.","Required":true},{"Key":"monitoring_plan","FieldType":"textarea","Label":"Monitoring, Audit, and Review Plan","HelpText":"How will you monitor performance, privacy, and fairness in production? Include metrics, frequency, and responsible owners.","Required":true},{"Key":"documentation_and_records","FieldType":"checkbox","Label":"Required Documentation to Attach","HelpText":"Check items you will attach to the assessment.","Options":[{"Value":"data_map","Label":"Data map / schema"},{"Value":"training_data_snapshot","Label":"Training data snapshot"},{"Value":"model_card","Label":"Model card / datasheet"},{"Value":"consent_records","Label":"Consent records"},{"Value":"vendor_contracts","Label":"Vendor contracts / DPA"},{"Value":"risk_tests","Label":"Re-identification / bias test results"}],"Required":false},{"Key":"privacy_officer_review","FieldType":"yesno","Label":"Has the privacy officer / legal reviewed this assessment?","HelpText":"Indicate whether the formal privacy/legal review occurred.","Required":true},{"Key":"approval_required_roles","FieldType":"checkbox","Label":"Approvals Needed","HelpText":"Select required approvers before deployment.","Options":[{"Value":"privacy_officer","Label":"Privacy Officer"},{"Value":"legal","Label":"Legal / Compliance"},{"Value":"business_owner","Label":"Business Owner"},{"Value":"security","Label":"Security / InfoSec"},{"Value":"ethics_board","Label":"Ethics Board / Committee"}],"Required":true},{"Key":"approver_signatures","FieldType":"textarea","Label":"Approver Names, Roles, and Sign-off Dates","HelpText":"Record the names, roles, and dates of approvers who accepted the risk and mitigations.","Required":true},{"Key":"review_cadence","FieldType":"select","Label":"Review Cadence","HelpText":"How often will this assessment be reviewed?","Options":[{"Value":"quarterly","Label":"Quarterly"},{"Value":"biannual","Label":"Bi-annual"},{"Value":"annual","Label":"Annual"},{"Value":"on_change","Label":"On major change or data source update"}],"Required":true},{"Key":"notes_and_followups","FieldType":"textarea","Label":"Open Notes, Risks to Track, and Follow-up Actions","HelpText":"Capture open items, owners, and deadlines for follow-up.","Required":false}]}