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Data Incident and Breach Report Form

Please refer to the University of Warwick's Personal Data Breach Procedure before completing this Personal Data Breach Form.

If you have any queries please feel free to contact the University's Data Protection Officer at


Incident/Breach Details

Does this incident/breach involve Personal Data
Were any of the following data types involved (if yes, tick all boxes that apply)
× Includes any inherited or acquired data which give unique information about the physiology or the health of that individual, resulting in particular from an analysis of a biological sample from the individual in question. † Any personal data resulting from specific technical processing relating to the physical, physiological or behavioural characteristics of an individual which allows or confirms the unique identification of that individual, such as facial images, fingerprints, blood samples etc. ‡ Includes employment rates, crime rates, poverty status, education levels, life expectancy etc. ◊ Includes CVs, job application forms, job references, PDRs, development reviews, pension, payroll, sickness etc.
Does this incident/breach involve Commercially Sensitive Data?
If yes, what was the classification?
For link to classification type please visit this webpage -
Is the incident/breach ongoing?
Are you aware of or suspect any related or other data incidents/breaches in your department?

Privacy statement

Any Data processed will be processed in accordance with the University's Data Protection Policy. The University’s Data Protection Officer, A Bajaj, can be contacted through and any requests or complaints should be made in writing to the University’s Data Protection Officer.

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