Continuous Improvement Form
Staff Member Requesting IRO
Date IRO Lodged
Reviewing Officer
Opportunity for improvement
(Issue)
Method of Lodgement
(please circle) Face to face Via email Hard copy Other
IRO Authorising Officer
Date IRO Acknowledged
Complexity
(please circle) (1 simple - 5 complex) 1 2 3 4 5
Estimated Timeframe
Proposed Action
Outcome
Effectiveness of Action
Version 1.1
Date IRO Actioned
Version 1.1