MANAGEMENT ACTION REQUEST (MAR) MANAGEMENT ACTION REQUEST (MAR) MAR No.

Corrective Action Preventive Action Opportunity for Improvement Source Reference Comment Internal / External Audit Management Review Customer Complaint Product Deficiency Previous MAR Other: Description of Actual or Potential Problem or Opportunity for Improvement (condition found):

Initiated by: Date Initiate Received and Entered into MAR System by: Date: Assigned to: Reply Due Date: Root Cause Immediate Action (to correct problem, minimize risk or achieve short term benefits):

Planned Completion Date: Long Term Action (to prevent occurrence/recurrence of a problem, or achieve long term benefits):

Submitted by: Comments by Approval Authority:

Planned Completion Date: Date Action Plan Submitted:

Approved by: Followed Up by: Effective? Closed Out by:

Yes

No

Date Action Plan Approved: Date of Follow Up: Evidence: Date Closed Out:

CONTINUAL IMPROVEMENT FORM (CIF) Organization: Base line information * 1. Improvement objective reference number: 2. What is to be improved? 3. Baseline performance Date first recorded: 4. Target performance 5. Target completion date Continual Improvement Form (CIF)

Progress information * 6. As of Date 7. Progress summary 8. Current performance 9. Reported by:

10. MAR Reference

11. Status

12. Recommendations

13. Recommended by:

14. MAR Reference

15. Summary of Action and Resources Needed

16. (new) Target performance (if applicable)

17. Responsible Manager:

18. Approved by:

20. Date approved: