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Data Incident and Breach Report Form

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

Incident/Breach Details

Does this incident/breach involve Personal Data
Does this incident/breach involve Personal Data
Were any of the following data types involved (if yes, tick all boxes that apply)
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?
Does this incident/breach involve Commercially Sensitive Data?
If yes, what was the classification?
If yes, what was the classification?
For link to classification type please visit this webpage - https://warwick.ac.uk/services/idc/informationsecurity/handling/classifications
Is the incident/breach ongoing?
Is the incident/breach ongoing?
Are you aware of or suspect any related or other data incidents/breaches in your department?
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, can be contacted through DPO@warwick.ac.uk and any requests or complaints should be made in writing to the University’s Data Protection Officer.

Spam prevention

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

Data Protection Officer
dpo@warwick.ac.uk
The University of Warwick
University House
Coventry CV4 8UW