Failure Analysis / Corrective Action Report

Customer Name: Part Number.: Failure Report No.:

Failed Description:

Lot size: Failure size: Failure Rate Other:

Description of Trouble (First Symptoms):

DATA

Describe Action Taken (Cause of Trouble, if known): Action By Date

FAILURE

Summary of Root Cause:

ANALYSIS

Analysis Done By
Date:

Recommended Corrective Action:

CORRECTIVE
ACTION

Board Review Action Taken By

Date ___________ Date:

Effectiveness of Corrective Action: Follow Up Done By
FOLLOW UP

FOLLOW

Date ____________
Further Recommendations:

BOARD
Detailed failure analysis, defining the root cause for this deficiency; and corrective action to eliminate
recurrence, along with the date of implementation.

BOARD CHAIR Program/Project Mgr. QA/QC Manufacturing Engineering

Date

BOARD RECEIVING PARTY

BOARD CHAIR Program/Project Mgr. QA/QC Engineering Comments /
Date Recommendations

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