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CAPA Request Form 6

This CAPA request form documents a corrective and preventive action plan for a quality assurance department. It includes details of the recommended changes such as the product or material name, document number and type, reference batch or effective date. It also provides space to describe the recommendation, rationale, remarks from those responsible, and a traceability matrix to track the changes. Sign-off is required from those performing and verifying the action as well as the evaluator.

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berk
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75 views

CAPA Request Form 6

This CAPA request form documents a corrective and preventive action plan for a quality assurance department. It includes details of the recommended changes such as the product or material name, document number and type, reference batch or effective date. It also provides space to describe the recommendation, rationale, remarks from those responsible, and a traceability matrix to track the changes. Sign-off is required from those performing and verifying the action as well as the evaluator.

Uploaded by

berk
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CAPA REQUEST FORM

Page 1 of 2

To Be Filled By QA Department

Department: Issued By (Name):


Issued On :
CAPA No. : Sign & Date:

Target Completion Date : Extended Target Completion Date:

CAPA Recommended As Per:

Product Name / Material Name


Document No.
Document Name (Type)
Any Other (Specify) :
Ref. Batch No. / Effective Date

Responsible Person

Details of Recommendations:

Rational:

Remarks By Responsible Person:


Page 2 of 2

Traceability Matrix:

Product Name / Matrix Name

Document Name

Document No.

Page No. / Step No.

Batch No,

Any Other

Supporting Data Attached Yes No

Remarks By Evaluator:

Concerned Department Evaluated By QA

Action Performed By Verified By

Signature

Date

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