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Change Request Form Template

This change request proposes identifying and analyzing a requested change to a project. If authorized, the change would impact the project's objectives, outputs, budget, and time schedule. The project manager analyzed the request and recommended whether or not the change should be implemented. Ultimately, the person approving changes for the project made a decision to authorize, authorize with amendments, or reject the requested change.

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chahi
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269 views2 pages

Change Request Form Template

This change request proposes identifying and analyzing a requested change to a project. If authorized, the change would impact the project's objectives, outputs, budget, and time schedule. The project manager analyzed the request and recommended whether or not the change should be implemented. Ultimately, the person approving changes for the project made a decision to authorize, authorize with amendments, or reject the requested change.

Uploaded by

chahi
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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Change request

1. BASIC INFORMATION ON THE CHANGE REQUESTED


Project name Insert project identification, programme or tasks which the
change concerns.
Identification of Insert the description of the change requested.
changes
Request placed by Anybody Contact Insert your contact
details details
Description of Explain the change including the proposed action.
requested change
Date of raising the dd/mm/yyyy Requested deadline dd/mm/yyyy
request for dealing with the
change request
Priority Low Medium High Essential
Justification for Justify why you are requesting that this change should be carried
change out
Comments Insert any other potential comments.
Annexes or references Yes No Name of the annexe or
reference
Insert the identification of the annexe or reference related to the
change proposed.

2. ANALYSIS OF THE CHANGE REQUEST


Impact on the What will the impact of the change on project objectives and
objective/outputs outputs be?
Impact on the budget What will the impact on the project budget be?
Impact on the time What will the impact on the time schedule of the project be?
schedule
Other impacts What other impacts will the change bring?
Comments Insert any other potential comments.
Recommendations Insert your recommendations, if and how the change should be
Y/N; procedure implemented.
Analysis carried out Project manager Date dd/mm/yyyy
by

3. DECISION ON CHANGES
Decision Authorised Authorised Rejected More
with information
amendments
Justification of the Insert your justification.
decision
Comments Insert any other potential comments.
Who will provide Insert the name of the person responsible for informing the stakeholders
information about the change.
Approved by Depending on change classification Date dd/mm/yyyy

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