Data breach form

Data submitted via this form will be handled in line with the University of Surrey's information management policies.

Contact details
Details about the incident
Was any personal data involved in the incident?
Was any special category data involved in the incident?
Did it involve any confidential information about the University?
Was the breach due to the data being:
Please tick all boxes that apply.
Was the data protected in any way?
Has anyone been notified of the breach?
Privacy notice

Please note that the reason for collecting your personal data is to enable us to respond to and action the data breach.

The University is the data controller in relation to the personal data that you are providing and the data you have given us will form part of the records held by the University.

It will be kept by the University for a period of seven years from the date of the last action taken in respect of the breach and then destroyed securely.

If you have any questions please contact our Data Protection Officer at:

Please read our Data Protection Policy (PDF).