Corrective Action Form

CAF # Date Opened:

Originator: Date Due:
Issued To: Date Closed:
Type of Corrective Action: Internal Supplier 3rd Party Customer
Found During: Internal Audit Production Inspection Other
Corrective Action Function Corrective Preventive Re-occurring Other

Problem Description: (For Specific Supplier Information See Below)

Quality Impact High – 3 days Medium – 7 days Low – 15 days

Supplier Corrective Action Information

Part Number Part Description Spec / Drawing

Qty Received Qty Nonconforming Lot Number PO Number

Disposition Plant Containment (MDR/Hold tag)

Containment: (Immediate Response for RGA#) Supplier or Customer Complaint section only
a) Check parts in production (Include Sampling Plan): -
b) Check parts in inventory (Include Sampling Plan): -
c) Follow up on parts in transit: -
Returned Goods Authorization (Product to be Returned) RGA#
Completed By: Date:

Root Cause: To Be Completed By Owner / Supplier:

Completed By: Date:

Corrective Action:
Short term & date to be completed:

Long term & date to be completed:

Completed By: Date:

Corrective Action Acceptance

ACCEPT REJECT
If Rejected, give explanation:
Completed By: Date:

Follow Up Corrective Action Verification:

After subsequent shipment of product, is the corrective action effective? YES NO
Comments:
Completed By: Date Closed: