Cyber Security Incident Reporting Form

Use this form to report security incidents to the University Information Security Officer. If additional information is required, you will be contacted via phone or email. To assist with our initial assessment and investigation, please provide as much information as possible.

Reporters Contact Information
Name Name * First Last
ODU MIDAS ID
Email *
Phone Phone - ### - ### ####
Select Incident Category
Incident Categories *

Incident Categories Potential unauthorized disclosure or alteration of non-public University Data Defacement of a University website Malicious/Vulnerable Code Misuse of Systems (internal or external) Threat/Harassment via electronic medium Vulnerability/Active Exploit on ODU System Intrusion to Steal Data Intentional Insider Threat Denial of Service Unintentional Data Discolsure Ransomware Theft or loss of equipment
Date of Incident Date of Incident / MM / DD YYYY
Incident Description and Systems Affected *
Incident Evidence

Attach Files

Cyber Security Incident Reporting Form

Cyber Security Incident Reporting Form

Reporters Contact Information

Select Incident Category