Corrective Action Request Form

Corrective Action Request

Instructions:
1. Indicate the product name, lot/batch number, and date received.
2. Select the source of the need for corrective action to be taken.
3. Take/attach photos and create an action where you can specify the details of the corrective action and set the assignee, priority level, and due date.
4. Sign off with your digital signature to complete the corrective action request.

Reference product name

Lot/batch number

Date received
Source

Specify major/minor product nonconformity

Identify person

Test type

Product result

Specify

Take/attach relevant photos and create an action
Completion

Additional comments

Quality Manager Name & Signature