# AI functional risk assessment

Connect a specific failure to its consequences, controls, tests and residual-risk decision.

Adapt this worksheet to your applicable procedures, intended use and requirements. Fictional examples are teaching material, not execution evidence.

## Field instructions

- **Requirement or function:** Identify the specific intended behavior and stable requirement ID.

- **Failure and cause:** Describe a missed, wrong, unauthorized or unavailable behavior and credible contributing factors.

- **Consequence and severity:** Trace the process effect and apply the organization’s severity rubric.

- **Existing control:** Identify the control that interrupts the failure, including its owner.

- **Control evidence:** Link tests or other evidence showing the control works.

- **Remaining gap:** Record uncertainty, failed criteria and unresolved controls.

- **Residual-risk decision:** State accept, restrict, defer or other locally defined disposition with rationale.

- **Owner and trigger:** Identify who acts and which change or result triggers reassessment.

## Blank worksheet

System / record ID: ____________________

Prepared by / date: ____________________

Required review / approval under local procedure: ____________________

| Field | Your entry |
| --- | --- |
| Requirement or function | ____________________ |
| Failure and cause | ____________________ |
| Consequence and severity | ____________________ |
| Existing control | ____________________ |
| Control evidence | ____________________ |
| Remaining gap | ____________________ |
| Residual-risk decision | ____________________ |
| Owner and trigger | ____________________ |

### Blank results or assessment rows

| Risk / requirement | Failure and consequence | Control and evidence | Residual decision |
| --- | --- | --- | --- |
| ____________________ | ____________________ | ____________________ | ____________________ |
| ____________________ | ____________________ | ____________________ | ____________________ |
| ____________________ | ____________________ | ____________________ | ____________________ |