Mandatory Breach Reporting Amendment Cover Page

Document Purpose and Overview

The purpose of this document is to notify the Office of Information and Privacy Commissioner of Alberta (OIPC) of the changes you are making in your clinic and what will be in the attachments for the OIPC to review. This page also authorizes the changes being made by the lead custodian.

Instructions for Use

If mandatory breach reporting is the only change you are making, this completed letter can go as a stand-alone document.

If you are making other changes, please make sure you add the mandatory breach reporting (and supporting documents) to that amendment. You can use the wording in this cover letter for the relevant acts and wording. 

• Fill in the highlighted sections and remove all highlighting.
• The lead custodian must sign the document.
• Attach relevant documents to the cover letter and send as one package to the OIPC.

Download Word Template