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Data protection breach questionnaire

It is not possible for us to accept every case and we have to reject many of the enquiries we receive. In order for us to assess your case we will require basic details, such as your name and contact email as well as some basic information about your case. Providing us with these details is not a guarantee that our case review panel will accept your case. You will be notified by email about whether your case has been accepted or not but we do not provide reasons for our decision to reject a case. 

Fields marked with a * must be completed.

Please select your title
Please enter your first name
Please enter your surname
Please enter your phone number
Please enter your mobile number
Please enter your email
  Please confirm date of breach
  Please confirm who caused the breach
  Please confirm impact of the breach
  Please confirm
  Please confirm
Please enter your town
Please select your preferred contact method
Please select how you heard about us
Please enter the verification code
Submitting your details indicates your consent for a member of our team to contact you about your enquiry and obtain feedback regarding our service.  To learn more about how we keep your information safe please read our privacy policy.