Your name*
Your email*
C/PAR #:*
Root Cause(s) of the Condition:* [(Focus on (potential) failures in the system)] [5-why approach: keep asking "Why?" until a procedural answer is found] [also you may use 7-step, 8-D or other root cause technique)] [(The root cause will point to a process, not a person]
Containment and Corrective Actions:* [immediate action(s) to address the condition or statement of finding] [Corrective/Preventive Action(s): (systemic fix to root cause)]
Verification and Effectiveness of Action(s):* [evidence for the implementation and effectiveness of the action(s)]
"Verification"/"Closed" Name and Date:*