Template AGP-TPL-01

AI Impact Assessment Template

Record an AI use case, the people it affects and the measures needed to address potential harm.

In preparation

What it’s for

Record an AI use case, the people it affects and the measures needed to address potential harm.

Who it’s for

AI project owners, privacy specialists and risk teams reviewing proposed or existing AI uses.

Inside the document

Planned contents — may change before release

  1. AI system and intended use
  2. Affected people and stakeholders
  3. Potential impacts and safeguards
  4. Residual risk and review decisions
  5. Approval and reassessment record

References, not certification

The planned reference points below guide the document’s scope. They do not imply endorsement, certification or a guarantee of compliance. Applicability depends on your organisation, activities and jurisdiction. These templates are not legal advice.