corrective action request (car) form - Totalqualityassociates.org

Total Quality Associates
CORRECTIVE ACTION REQUEST (CAR) FORM
This form has been provided by TQA. Internal auditors are encouraged to use his form, to document any
major or minor non-conformances with their internal procedures and/or external standards. Internal
Auditor to complete Section A. The area Manager should complete Sections B and C with signature and
date. The area Manager should approve the Corrective Action Plan in Section D and Close the
Corrective Action in Section E.
Group/Organization Name: Date: CAR #:
Internal Auditor:
A. Describe the Major or Minor Non-Conformance
Major: Minor:
Internal Auditor Signature:__________________ Date:___________________
B. Identify the Corrective Action by the Group Organization, Manager or Member:
C.
Estimated Completion Date:____________ Person Responsible:______________
D. Identify the Root Cause of the Non-Conformance:
E.
Identify Preventive Action to ensure that the Non-Conformance does not recur.
Completion Date:_________ Person Responsible:_________________________
D. Corrective Action Plan Approved: (Comments)
Group Manager Signature:____________________ Date:_______________
E. Corrective Action Closed: (Comments)
Group Manager Signature:____________________ Date:_______________
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Total Quality Associates
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