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FM - 12 Corrective Action Request

This document is a corrective action request form regarding a nonconformity. It contains sections for classifying the nonconformity, detailing it, identifying the root cause, outlining proposed remedial and corrective actions with targets dates, accepting the proposed actions, and verifying that corrective actions were completed. The form is used to document nonconformities found during internal audits and ensure corrective actions are proposed and tracked to resolution.

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849 views1 page

FM - 12 Corrective Action Request

This document is a corrective action request form regarding a nonconformity. It contains sections for classifying the nonconformity, detailing it, identifying the root cause, outlining proposed remedial and corrective actions with targets dates, accepting the proposed actions, and verifying that corrective actions were completed. The form is used to document nonconformities found during internal audits and ensure corrective actions are proposed and tracked to resolution.

Uploaded by

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

Corrective Action Request

Part 1 – Classification

1- Product Nonconformity 2-Customer Complaint 3- System Audit 4- Data Analysis

Issued To: Department: CAR #:

CC: Subcontractor: Audit Ref No:


Part 2

Category Document &


Details of Nonconformity
Major - Minor Clause Ref

Root Cause of the Non-Conformity


1- Deficiency in System Implementation 4- Deficiency in Communication 7- Deficiency in Tools / Equipment
2- Deficiency in Documentation 5- Deficiency in Required Competency 8- Deficiency in Operating Environment
3- Deficiency in Required Human
Resource 6- Deficiency in Materials 9- Deficiency in Training & Motivation

Issued by QA Manager Auditee Re-assessment Required


Name & Signature: Name & Signature: Yes - No
Date: Date: Date:

Part 3
Proposed Remedial Action {Attach separate sheet if required} Action By Target Date Status

Corrective Measures {Attach separate sheet if required}

Note: Once the Corrective & Preventive Actions Are Completed, Initial the Status Column & Notify the QA Department for Re-
Assessment

Part 4 Proposed Corrective / Preventative Action Accepted: Yes - No


Department Manager Suppliers / Subcontractors QA Manager
Name & Signature Name & Signature Name & Signature
Date Date Date:

Part 5 Corrective actions Verified as Completed & Accepted: Yes - No


QA Manager - Name: CAR Closed, Yes - No

Signature Date:

Note: 1- This Form can only be used during Internal Audit

FM - 12 / Rev0
Page 1 of 1

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