SafetyCulture Staff

5 Whys Form Template

A 5 whys form template is used by business teams to drill down to the root cause of a problem using the 5 Whys technique. This template has been designed to make it easier for teams to ask and answer the question, "Why did this problem occur?" 5 times to discover the root cause. Take or attach relevant photos with the use of this template and complete this digitized 5 whys form with electronic signatures.

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Title Page

Department
Full Name of Team Leader
Location
Conducted on

5 Whys

Indicate a recurring problem in the organization
WHY 1
Why did this problem occur?
Take/ attach relevant photos.
WHY 2
Why did this problem (why 1) occur?
Take/ attach relevant photos.
WHY 3
Why did this problem (why 2) occur?
Take/ attach relevant photos.
WHY 4
Why did this problem (why 3) occur?
Take/ attach relevant photos.
WHY 5
What is the root cause of the problem?
Take/ attach relevant photos.
What can be a solution to the root cause of the problem?

Completion

Additional Suggestions
Full Name and Signature of Team Leader

SafetyCulture Staff

5 Whys Form Template

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.