Personal Data Breach Claim

This form is for you to complete if you believe your personal data has been compromised by a third party and you wish to bring a civil claim for compensation. At this stage we ask that you do not include any sensitive personal data which may have been involved in the breach when completing this form. For example, if the effect of the breach was that your sensitive medical health records have been wrongly disclosed to someone else, please do not provide us with what the specific details are. This type of information is known as ‘special category’ data and we may ask for it later.




Name

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Email Address

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Phone Number

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Name of the third-party/ organisation

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Address of third-party/ organisation

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How do you know the third-party/ organisation

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About The Breach




What has happened?

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Was the breach caused by a cyber incident?

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How did you find out about the breach?

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When did the breach happen

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What type of your personal information was included in the breach? (tick all that apply)

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If 'Other' selected, please specify

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Potential consequences of the breach

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Please give details of anything else you believe is relevant

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Make a free enquiry, call now

0151 659 1070




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Please let us know your message.



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I understand that by submitting my query to you, my personal data (name, email address and contact number) will be processed by you in order to contact me and assist me with my query. I confirm I have read and understood the Privacy Notice and I consent to you processing my data for the purpose of contacting me to assist me with my query.




How can we help you?

To find how our friendly and knowledgeable solicitors can help you, contact us today.

Make a free enquiry - Call now - 0151 659 1070