Nonconformance Report

• NONCONFORMANCE REPORT

• Client / Site

• Conducted on

  Date
• Location
  Address

• Add media

  Media

SECTION 1: To be completed by initiator

• Initiator Name

• Title

• Select date

  Date

• Street Address

• City/State/Zip

• Phone

• FAX

• E-Mail

• Part/Process Name

• QTY Affected

• P.O. Number

• Part Number

• REV

• REV Date

  Date

• Nonconformance Type (Check All That Apply)

  Select Dimensional Process Procedure Documentation Purchase Order Material

  • Dimensional
  • Process
  • Procedure
  • Documentation
  • Purchase Order
  • Material

• Description Of Nonconformance

• Delivery, Schedule Or Cost Impact

Section 2: AM QUALITY NCR REVIEW

• Date

  Date

• QA Name

• NCR Rejected

• NCR Accepted

• QA Phone

• E-Mail

• Defect Code

• Forward To:

• Notes

• Department Code

• Nonconformance Category

  Select Critical Major Minor Concern Observation

  • Critical
  • Major
  • Minor
  • Concern
  • Observation

• CRITICAL : Could lead to a life threatening product liability or extreme safety hazard situation. Review and response is required upon finding.
  
  MAJOR: Proven to be systematic and in direct conflict with said standard requirement. Response and completion of action items is required within (2) working days.
  
  CONCERN: Any set of circumstances, which although is not a Nonconformance, could lead to a Nonconformance within the quality system. Response is not required, but recommended as reviewed by the quality NCR Administrator or qualified as assigned delegate.
  
  OBSERVATION: A positive or negative fact within the quality system. Response is not required, but recommended for continuous improvement as reviewed by the QA Administrator or qualified assigned delegate.

Section 3: Corrective And Preventive Action (CAPA)

• Corrective Action

• Response Due By:

  Date

• Preventive Action

• Response By:

• Title

• Date

  Date

• Phone Number

• E-Mail

• Fax

Section 4: Quality Review Of CAPA

• Disposition Notes:

• NCR Closed?

  Yes

  No

• Follow Up Audit Required?

  Yes

  No

• Audit Assigned To:

• Audit To Be Completed By:

• NCR Administrator:

• Add signature

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