Report a Loss of Confidential Information

This form is used to document a suspected theft or loss of student or employee confidential information at Shawnee State University. Shawnee State offers a comprehensive definition of student, staff or faculty information residing on University or personally-owned storage devices that is considered confidential in nature, in the Conditions for Network and Computer Use document.

Information submitted on this form will be forwarded to UIS for evaluation. It may also be shared with other SSU employees charged with the task of identifying SSU’s responsibility for notification to impacted individuals under state or federal law, in cases of confirmed loss or theft of confidential data.

Reporting suspected violations of the Conditions for Information Security is the responsibility of all members of the University community. If you suspect that SSU confidential information has been lost or stolen, please complete the inquiry below to the best of your knowledge and submit the form. UIS places a priority on protecting institutional data defined as confidential, and will take immediate action as a result of submission.

Point of Contact (POC) Information
Information Format
Was Data Transmitted Electronically Offsite
Electronic Data Format
Electronic Media Format
Data Accessibility
Is Unauthorized Access to Data Currently Possible
Missing Hardware Identified
Hardware Type
Hardware Manufacture
Is Hardware Owned by SSU
Is Unauthorized Access to Hardware Currently Possible