Online Privacy Breach Report Form

Public bodies and private sector organizations may use this online form to self-report a privacy breach to the Office of the Information and Privacy Commissioner. Do not use this form if you are making a complaint about the way a public body or organization has collected, used, disclosed or secured your personal information.” 

Please submit this form as soon as possible. It is not necessary to have every field filled, as long as you can provide us with enough information to start a file (contact information and a summary of the breach).  You will be prompted to put information in each field but can input “tbd” if information is not yet known but will be provided later or “na” if no information will be provided.  To use the form to provide additional information, include the term “follow-up” in the public body or organization field.  Alternatively, if you have been assigned to an intake officer or investigator you can provide them with follow-up information directly.

In the final step of this form, you can attach PDF and Word documents to supplement your time extension request. Form content and attachments are encrypted in transit and in storage.

Once you submit the form you will have the option to print a copy for your records.

Step 1: Contact Information
Name of public body or organization
Contact Name
Contact's title
Contact's direct phone number
Enter your phone number, including the area code, separated by dashes (XXX-XXX-XXXX)
Contact email address
Step 1