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Formulario SAC

This document is a template for a Corrective Action Request (CAR) form. It includes fields to identify the type and source of the issue, assign priority levels, and describe the problem, containment actions, root cause analysis, corrective action plan, and verification of effectiveness. The form is submitted to the CAR Administrator for processing and assignment to an individual for resolution.

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Jose Antonio Medrano Garcia
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18 views

Formulario SAC

This document is a template for a Corrective Action Request (CAR) form. It includes fields to identify the type and source of the issue, assign priority levels, and describe the problem, containment actions, root cause analysis, corrective action plan, and verification of effectiveness. The form is submitted to the CAR Administrator for processing and assignment to an individual for resolution.

Uploaded by

Jose Antonio Medrano Garcia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Enumere sus Enter full name of

Procesos Aquí CAR form here


Proceso 1
Proceso 2 Enter abbreviated
Proceso 3
name of your CAR
Proceso 4
Proceso 5
form here
Proceso 6
Proceso 7
Proceso 8
Proceso 9
Proceso 10 Enter name or title of
CAR Administrator
here
Solicitud de Acción Correctiva

For example, "Corrective Action Request"

For example, "CAR"

For example, "John Smith"


#
Solicitud de Acción Correctiva () - Rev 0
00
00
Type Corrective Action (existing issue) Preventive Action (potential issue) Name:
Check one
Opportunity for Improvement / Suggestion Date:

Employee Feedback Customer Feedback ✘ Supplier / Subcontractor Feedback


Source External Audit Internal Audit ✘ Management Review Action Item
Check one Finding Finding
Other:

Proceso 1 Proceso 2 Proceso 3


Proceso 4 Proceso 5 Proceso 6
Proceso
Elegir Uno Proceso 7 Proceso 8 Proceso 9
Proceso 10 Other:

Priority
Check One Low Medium High Urgent / Critical

Describe the issue or problem in detail.

Stop here. Submit to

Assigned to: Date Assigned: Respond by:


To be completed by the Assignee.
Containment / Immediate Corrections: (Required only for corrective action requests.)

Root Cause of Problem: (Required for all corrective and preventive issues; optional for suggestions for improvement.)

Action Plan: (Actions taken to eliminate root cause, resolve issue and prevent recurrence.)

Date Action Completed: Name:


Stop here. Return to

Effectiveness verified by: Date:


PASS FAIL: Returned for Further Processing
Result: PASS FAIL: Returned for Further Processing

Notes and
justification:

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