Change Management Document
Project Name
Project Manager
Date
Document Classification
Change Details
Change Request ID
Requestor Name
Role
Contact Information
Date Submitted
Priority
Summary (Brief summary of the change)
Detailed Description (A more detailed explanation of the change, including what triggers it
and its intended outcomes.)
Justification (Please outline the purpose of this change and the expected outcome)
Impact Analysis
Affected Services (Please list all affected areas, process or functions impacted)
Area Impact
Technical Impact
Schedule Impact
Cost Impact
Risk Impact
Approvals
Technical Lead
• Name:
• Signature:
• Date:
Project Manager
• Name:
• Signature:
• Date:
Stakeholder
• Name:
• Signature:
• Date:
Change Implementation
Implementation plan
Please list activities for implementation of the change
Owner Action Due
Backout Plan
Please provide details of how the change could be reversed if necessary
Additional Notes
Please provide any additional information or insights related to this change request
Post-Implementation Review
Summary
Overview of the change after it has been implemented, including whether it met its
objectives.
Lessons Learned
Any lessons learned during the change process.
