Resources / Reference
AI Use Case Intake Form
A ready-to-use form for requesting and approving new AI tools and uses.
AI Use Case Intake Form
Requester
| Name and department | |
|---|---|
| Business owner for this AI use |
The AI use
| Tool or vendor name | |
|---|---|
| What will the AI do? | |
| Who will use it, and who will it affect? | |
| Will it make or influence decisions about people? (yes / no) |
Data
| What data will the tool receive? | |
|---|---|
| Does it include personal, confidential, health, or financial information? (yes / no) | |
| Will the vendor store or train on our data? (yes / no / unknown) |
Risk and approval
| Proposed risk tier (high / medium / low) | |
|---|---|
| Controls in place (human review, access limits, testing) | |
| Reviewer comments | |
| Decision (approved / approved with conditions / declined) and date |
Free to use and adapt. Want it tailored to your organization? Our AI Acceptable Use Policy package and AI Governance Starter bundle include a customized version.
This page is general information for planning purposes. Laws and guidance change, so confirm current requirements before acting. It is not legal advice. For legal advice about your organization, consult a licensed attorney.
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