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Change Request Form

This change request form is used to document a proposed change to a project. It collects information about the requested change including the reason, potential alternatives, and impact on schedule, budget, quality assurance and existing work products. The form is submitted to project management for review and decision on whether the change is approved, rejected, approved with modifications, or deferred.

Uploaded by

Ivan Meštrović
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© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
126 views

Change Request Form

This change request form is used to document a proposed change to a project. It collects information about the requested change including the reason, potential alternatives, and impact on schedule, budget, quality assurance and existing work products. The form is submitted to project management for review and decision on whether the change is approved, rejected, approved with modifications, or deferred.

Uploaded by

Ivan Meštrović
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Change Request Form

Project Name Date


Project Number Requestor
Project Manager Project Owner

Describe the Requested Change

Describe the Reason for the Request

Describe Alternative Options


Risk Identification/Analysis

Impact Analysis
Work Products to be Modified Version Number
1.
2.
3.

Describe the impact of the suggested change to work that is already complete.

Quality Impact
Additional Quality Assurance or Quality Control Activities
1.
2.
3.

Describe the impact of the change to quality assurance activities and quality control activities.

Change Request Form 1


Schedule Impact
New Deliverables Description Effort Date Impact to Other Delivery
Hours Required Dates
1.
2.
3.

Based on the impact, state the estimated date for implementing the requested change. State the new estimated project
completion date.

Budget Impact
New Deliverables Description Lessen or Eliminate Other Cost of New Total
Expenses? Please describe. Deliverable
1.
2.
3.

Describe the overall impact to budget/cost.

Decision
Approved Rejected
Approved with modifications Deferred

Justifications

Additional Comments

__________________________________ ________________________________
Approver’s Printed Name Date

__________________________________
Title

__________________________________
Signature

For additional project management templates visit www.mypmllc.com/project-management-resources/free-


project-management-templates.
Change Request Form 2

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