Corrective Action form
Section audited Date Auditor
Audit criteria Document No. and clause
Statement of the requirement:
Nonconformity
Medical significance Yes No.
Classification Major Minor
Auditor Name Auditee Name
Signature Signature
Date Date
Root cause
Implementer Date
Correction (specify if immediate correction was different from the corrective action)
Implementer Date
Corrective action to prevent recurrence
Implementer Date
Follow up to close nonconformity
Implementer Date
Effectiveness of the corrective action to be checked during the next audit
Auditor Name Date