Corrective Action Form

Name of Facility: ____________________________________Testing Point: ______________________

Date of Occurrence: ___________________Date of Reporting: _________________________________

Category of Occurrence (Tick as appropriate):

PT Failure QC Failure Audit Nonconformance Others

Problem/Explanation of Findings:

Root Cause Analysis:

Corrective Action/Preventive Action Taken:

Name of Tester/Signature/Date Name of Supervisor/Signature/Date