Skip to Main Content
Help Desk
Doctor on Call
Help Desk
Submit a ticket
Report Personal Data Breach
Submit a Support Request
Required fields are marked with
Name:
Email:
Priority:
Low
Medium
High
Which DOC service or system is affected:
Telemedicine Platform
Clinic
Pharmacy
Laboratory
Mobile App
Website
Email
Shared Drive / File Storage
Paper Records
Type of Personal Data Breach incident:
Unauthorised access
Unauthorised disclosure
Loss of personal information
Theft of records or device
Incorrect recipient
Misdirected email
Lost or stolen laptop/mobile device
Paper records lost
Improper disposal of records
Ransomware / Malware
System compromise
Categories of personal information were involved:
Name
Omang ID / Passport
Contact details
Medical records
Prescription information
Laboratory results
Financial information
Employee information
How many individuals are affected:
Who is affected:
Patients
Employees
Suppliers
Healthcare Partners
Unknown
Have any immediate actions been taken to contain the incident?
No
Yes
Please describe the actions taken about incident:
Location / Department where the concern occurred:
Subject:
Message:
Suggested knowledgebase articles:
The information provided is true and accurate to the best of my knowledge.
I confirm
This report will be used solely for investigating and managing the reported personal data breach in accordance with Doctor On Call's Privacy Program.
I understand
Attachments:
Add file
File upload limits
SPAM Prevention
Submitting, please wait...
(
)