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Issue from :

Internal Audit
External Audit
Customer Complains

CORRECTIVE ACTION RECORD


PREVENTIVE ACTION RECORD

Internal Complains
Nonconformity Process
Others :

Department :
DETAILS OF FINDING :
Issued
Date

:
:

Sign :

Reviewed & Approved :


Date
:

Sign :

ANALYZE / INVESTIGATION :
Date/Time

Description

Root Causes:
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
CORRECTIVE & PREVENTIVE ACTION PLAN :
No

Action

A.

Corective Action

B.

Preventive Action

FOLLOW UP / VERIFICATION :

Person
Responsible

Target of
completion

Distributed to :

Real of
completion

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