Data Breach Complaint Generator | Free HIPAA & PII Tool

What type of data breach occurred?

Choose the type that best describes your situation. This determines which legal template and protections apply.

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Standard Data Breach

Personal information, financial data, login credentials, or other non-medical data

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Healthcare/Medical (PHI)

Protected health information, medical records, or HIPAA-covered data

Your Information (Plaintiff)

Enter your personal details as they should appear in the complaint.

Full Legal Name *

Address *

Email Address

Email that was potentially compromised

Phone Number

Date of Birth

If this personal information was involved in the breach

Company Information (Defendant)

Information about the company that experienced the data breach.

Company Name *

Company Type

Industry

Business Description

Company Address

Data Breach Information

Details about the breach and what data was compromised.

Breach Type

Date of Breach Discovery *

When you learned about the breach

Notification Date

When the company notified you

How were you notified?

Email notification Physical letter Media report Company website Credit monitoring offer Phone call No notification received Other

Types of Data Compromised

Personal ID Information (Name, SSN, DOB)

Financial Information (Credit cards, bank accounts)

Protected Health Information (PHI) — HIPAA-covered

Medical Records

Login Credentials/Passwords

Other Sensitive Data

Breach Description

Security Failures & Company Response

What security measures failed and how the company responded.

Remedial Actions Offered by Company

Credit monitoring service Identity theft protection Identity theft insurance Refund or reimbursement Apology letter Password reset assistance Dedicated support hotline No remedial action offered

Damages and Impact

How this breach has harmed you personally.

Damages Suffered

Identity theft

Direct financial losses

Credit monitoring costs

Time spent addressing breach

Anxiety and emotional distress

Estimated Financial Impact

Include credit monitoring, identity theft losses, etc.

Impact Description

Court Selection

Where do you want to file this complaint?

Forum Type *

Review & Generate

Review your information and generate your complaint.

Breach Type

Your Information

Company

Court

Important Disclaimer

This is an experimental feature, and its products should not be assumed to be ready to file. These generated complaints are meant to serve as a starting point for your pro se litigation. These complaints are generated with AI, and AI can make mistakes. Be sure to check that the facts described here are correct.

Legal Disclaimer

WE ARE NOT YOUR LAWYER. This service provides document generation assistance only and does not constitute legal advice.

It is your responsibility to:

Comply with all local court rules, filing requirements, and procedural deadlines
Verify that all facts and legal claims in your complaint are accurate and supported by law
Review, edit, and customize the generated document before filing
Properly serve the complaint on all defendants according to applicable rules