Report a Privacy Breach – SelfDesign Support Request

Purpose

This form is for reporting suspected or confirmed privacy incidents/breaches. If in question, please report! We will work with you to complete a determination. Thank you for reporting.

Reporting a Phishing Email?

If you didn’t interact with a phishing email (e.g., no links were clicked, no information was shared), please use the "Report a Phishing Attempt" form instead.

Submission Recipient

Privacy Team

Name *

First

Last

Email *

Phone

Role *

Email of your Supervisor/Team Lead *

Submission Details

Please give as much detail as possible. Please do not provide actual personal information, only types of personal information such as “Parent A’s personal email address” or “Student’s name”. Thank you for reporting. Your commitment to privacy is appreciated.

Describe Incident *

Date Incident Discovered *

Number of Individuals Affected *

Types of Individuals Involved *

Select all that apply

Describe the Types of Personal Information Involved *

This submission will be received by the Privacy Team