QMS Change Management Form

• Project / Change Title

• Conducted on

  Date

• Prepared by

• Location

  Select

Information

• Change Initiator

• Description of Proposed Change (Note this process does not apply to Engineering/design changes)

• Background / Current Situation (attach or cross reference additional information, as required)

• Proposed Date and Time to implement Change

  Date

• Required Resources

  Select Time Money / Capex Outside expertise Others

  • Time
  • Money / Capex
  • Outside expertise
  • Others

• Estimate Cost to implement Change

Change Impact

• Does this change affect roles / responsibilities allocated:

  Yes

  No

  N/A

• Does this change affect quality processes, tasks and or document? is there an impact on system integrity and/effectiveness?

  Yes

  No

  N/A

• Reason For Request

  Select Process Improvement / Change IT or System Change Legal Requirement Organisational Changes Production process changes Asset dismantling disposal Documentation/Standards Administration Process

  • Process Improvement / Change
  • IT or System Change
  • Legal Requirement
  • Organisational Changes
  • Production process changes
  • Asset dismantling disposal
  • Documentation/Standards
  • Administration Process

• Duplicate the next section as needed to identify all area's impacted, consider details / Risks / Opportunities for each area. Create actions needed to complete tasks.

Area's identified as impacted by the proposed change: (Select one area at a time)

• Select area impacted / Effected by the proposed change:

  Select Production / Operations Equipment Procedures & Process IT Customer / Interested Parties Organizational context / Structure Administrative / Accounting processes Inventory Control Suppliers / service providers Emergency Procedures Work schedules / shifts Training Policy Reporting systems Drawing & Design Other

  • Production / Operations
  • Equipment
  • Procedures & Process
  • IT
  • Customer / Interested Parties
  • Organizational context / Structure
  • Administrative / Accounting processes
  • Inventory Control
  • Suppliers / service providers
  • Emergency Procedures
  • Work schedules / shifts
  • Training
  • Policy
  • Reporting systems
  • Drawing & Design
  • Other

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Details / Risks / Opportunities:

• Actions Completed

  Yes

  No

  N/A

• Training provided & Proposed changes communicated to employees

  Yes

  No

  N/A

• Proposed Change Approved or Rejected

  Approved

  Rejected

• Comments (Reason of Rejection)

• Approved/Rejected by: Name and signature

  Sign