Data Breach Log and Notification Form

The complete record for every breach and near miss – from the first report to the regulator notification and closure.

Editable Word document
9
10pages
Guidance notes included
aml consultancy solutions

Data protection & GDPR

Data Breach Log and Notification Form

About this document

What it’s for

The working record you complete during and after a personal data breach. Article 33(5) UK GDPR requires every breach to be documented, whether or not it is reported. This form captures the internal report, risk assessment, notification decisions, a worksheet for the regulator report, notices to individuals, lessons learned and an ongoing breach register.

When to use it

  • As soon as a breach or near miss is reported – one form per incident
  • Alongside the Data Breach Response Plan, which explains each step
  • When you prepare the online report to the Information Commission

What’s inside

The document is laid out in the sections below. Each one comes with a plain-English guidance note explaining what it does and what to change.

  • Part A – Initial internal report
  • Type of breach (tick all that apply)
  • Cause (tick the closest)
  • Risk assessment
  • Part D – Regulator notification worksheet
  • Part F – Lessons learned and closure

How to complete it

  • Part A can be completed by the person who found the incident
  • Parts B to F are for the Breach Response Lead
  • Add every incident to the breach register in Part G, including near misses
  • Keep completed forms securely – they often contain sensitive details

Key points to check

  • Record the date and time you became aware – the 72-hour deadline runs from then
  • Record reasons for every “do not notify” decision

Our templates are professionally structured starting points for UK businesses, not legal advice. For anything complex, unusual or high-value, have your final version checked by a solicitor.

Included in the pack

Data protection & GDPR

£20

for every document in this category

Editable Microsoft Word files

Guidance notes in every document

Written for UK businesses

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