SafetyCulture Staff

Supplier Corrective Action Request Form

This digital supplier corrective action request form includes action response from the supplier such as the containment action, recurrence root cause, implementation of permanent corrective actions, and measurement of their effectiveness.

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Title Page

Company
Address
Quality Manager
Date Issued

Supplier Corrective Action Request (SCAR) Form

General Information

Supplier
Part Name & Number
PO/Lot Number
Problem Description
Photo Evidence

Action Response

Containment action completed within 48 hours of SCAR issuance
Actual completion date of containment action
Photo evidence
Person responsible for containment action
Primary root cause(s) for reject occurrence
What was done to prevent recurrence and/or defect?
Implementation date of permanent corrective action
Photo evidence
Person responsible for permanent corrective action
How will the effectivity of the corrective action be measured?

Completion

Additional comments
Quality Manager Name & Signature

SafetyCulture Staff

Supplier Corrective Action Request Form

Use this Template

Print as PDF

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