Corrective Action Form - Fda

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ORA LABORATORY PROCEDURE
Document No.:
Version No.: 1.6
Food and Drug Administration
ORA-LAB.4.11
Page 9 of 9
Effective Date:
10-01-03
ATTACHMENT A
Revised:
Non-Conformance_Corrective Action Form Example
09-29-14
ID#_______
[NAME]
Non-Conformance_Corrective Action Form
Initiated by:___________________Supervisor___________________Date:___________
Affected Project(s) and/or Analysis:___________________________
Quality System Problem(s) and Findings:
Priority: Low __ Med __ High __
Root Cause Required: Yes __
Possible Causes and Major Area/Situations Investigated:
Findings and Causes from Investigation:
Conclusion (identified root cause)/Corrective Action:
Initiator:___________________Date:_____________Supervisor___________________Date:___________
Submitted to QSM:___________________
Date:__________
FOLLOW UP/:_______
Due Date:_________Date Closed: _____________
Monitoring
Findings:
Quality System Manager __________________
This document is uncontrolled when printed: 09/30/2014
For the most current and official copy, check the Internet at

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