Freedom of Information and Protection of Privacy: Privacy Complaint Form
Page2|2
Part 3: Resolution of Complaint
Please describe how your privacy complaint could be resolved:
Part 4: About the Process
Submit completed complaint forms to:
University Secretariat
University Centre, 4
th
Floor
50 Stone Road East
Guelph, Ontario
N1G2W1
The University Secretariat will investigate your complaint to ensure the immediate requirements of
containment and notification have been addressed, to review the circumstances surrounding the breach,
and to review the adequacy of existing policies, procedures, and training in protecting personal information.
Part 5: Complainant’s Consent
Consent to disclose your name to the department the complaint is related to:
I consent to my name being disclosed to the department in order to investigate this complaint
I do not consent to my name being disclosed to the department
Consent to provide a copy of documentation to the department the complaint is related to:
I consent to a copy of this form and all attachments being provided to the department
I do not consent to a copy of this form and all attachments being provided to the department
Part 6: Complainant’s Signature
Signature: Day: Month: Year:
Personal information on this form is collected under the authority of the University of Guelph Act, 1964 and in
accordance with Ontario’s Freedom of Information and Protection of Privacy Act. This information will be used
for the purpose of responding to your complaint. Questions about this collection should be directed to the
University’s privacy officer, University Secretariat, 519-824-4120 x.56571 or by email to fippa@uoguelph.ca.