SIPOC Template

• Site

• Conducted on (Date and Time)

  Date

• Officer in Charge

• Location
  Address

Suppliers

• Who is proving input to a process

Input

• Resource provided by suppliers to execute the process

Process

• Steps taken to convert input to a specified output

Output

• Product or services that result from the process

Customer

• Recipient of the process output

Completion

• Recommendations

• Officer in Charge (Full Name and Signature)

  Sign