Corrective Action Request (CAR) Form

Purpose

This form is used to document nonconformities and implement corrective actions to prevent recurrence. Corrective actions address the root cause of problems to eliminate them permanently, supporting our commitment to continuous improvement.

Instructions

1. Initiate: Complete Sections 1-3 when a nonconformity is identified
2. Analyze: The responsible person completes Section 4 (root cause analysis)
3. Plan: Define corrective actions in Section 5
4. Implement: Execute the planned actions
5. Verify: Confirm actions were effective (Section 6)
6. Close: IMS Coordinator reviews and closes the CAR

Section 1: CAR Identification

Field	Details
CAR Number	[Auto-assigned: CAR-YYYY-NNN]
Date Raised	[YYYY-MM-DD]
Raised By
Department/Area

Section 2: Source of Nonconformity

How was this nonconformity identified?

• Internal Audit Finding
• External Audit Finding (Certification Body)
• Customer Complaint
• Management Review
• Incident Investigation
• Risk Assessment
• Process Monitoring/Measurement
• Employee Observation
• Supplier Issue
• Regulatory Inspection
• Other: _______________________

Reference Number: [e.g., Audit report number, incident ID, complaint number]

Section 3: Nonconformity Description

3.1 What Went Wrong?

Describe the nonconformity objectively:

[What happened? What requirement was not met? Be specific and factual.]

Date/Time of Occurrence: [If applicable]

Location/Process: [Where did this occur?]

3.2 Evidence

Supporting evidence:

[e.g., Screenshots, photos, documents, data, witness statements]

Evidence attached? [ ] Yes [ ] No

3.3 Impact Assessment

What was the impact?

• Customer dissatisfaction/complaint
• Service disruption
• Security incident/data breach
• Environmental impact
• Regulatory non-compliance
• Financial loss (estimate: ________)
• Reputational damage
• Safety issue
• Process inefficiency
• No significant impact (near miss)
• Other: _______________________

Severity:

• Critical: Major impact on customer, compliance, or operations
• High: Significant impact requiring urgent attention
• Medium: Moderate impact, address within normal timelines
• Low: Minor impact, low urgency

3.4 Immediate Containment Actions Taken

What immediate actions were taken to control the situation?

[e.g., Customer notified, service restored, access revoked, workaround implemented]

Action	By Whom	Date

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Section 4: Root Cause Analysis

Assigned To: _____________________ Date Assigned: __________

4.1 Investigation Method

Analysis method used:

• 5 Whys
• Fishbone Diagram (Ishikawa)
• Fault Tree Analysis
• Process Mapping
• Data Analysis
• Other: _______________________

4.2 Five Whys Analysis

Problem Statement: [Restate the nonconformity]

	Question	Answer
Why 1	Why did this nonconformity occur?
Why 2	Why did that happen?
Why 3	Why did that happen?
Why 4	Why did that happen?
Why 5	Why did that happen?

Continue until you reach a root cause (the underlying issue that, if corrected, would prevent recurrence).

4.3 Root Cause(s) Identified

What is the fundamental root cause?

[The systemic issue that allowed this nonconformity to occur]

Contributing Factors:

• Inadequate process/procedure
• Procedure not followed
• Lack of training/competence
• Inadequate resources
• Communication breakdown
• Technology/system failure
• Inadequate controls
• Inadequate monitoring
• External factor (supplier, partner, etc.)
• Other: _______________________

Root Cause Category:

• People: Training, competence, awareness, human error
• Process: Inadequate, unclear, or missing procedures
• Technology: System failure, tool inadequacy
• Environment: Workplace, resources, external conditions
• Management: Oversight, resources, priorities

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Section 5: Corrective Action Plan

5.1 Planned Corrective Actions

List all actions to eliminate the root cause and prevent recurrence:

#	Corrective Action	Responsible Person	Target Date	Resources Required	Status
1					[ ] Not Started [ ] In Progress [ ] Complete
2					[ ] Not Started [ ] In Progress [ ] Complete
3					[ ] Not Started [ ] In Progress [ ] Complete
4					[ ] Not Started [ ] In Progress [ ] Complete

5.2 Prevention of Recurrence

How will these actions prevent this from happening again?

[Explain the linkage between the root cause and the corrective actions]

5.3 Broader Application

Should similar checks/changes be made in other areas?

• Yes - specify areas: _____________________
• No - this is isolated to the affected area
• To be determined

5.4 Documentation Updates

Do any documents need to be updated as a result of this CAR?

• Policies
• Procedures
• Guidelines/Work Instructions
• Forms/Templates
• Risk Register
• Training Materials
• Other: _______________________
• No documentation updates required

Documents to be updated: [List document IDs]

5.5 Approval

Corrective Action Plan Approved By:

Name	Role	Date	Signature

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Section 6: Implementation and Verification

6.1 Implementation Evidence

#	Action	Completion Date	Evidence of Completion
1
2
3
4

6.2 Effectiveness Verification

Verification Method:

• Follow-up audit
• Process monitoring/measurement
• Review of records
• Customer feedback
• Staff feedback
• Testing/simulation
• Other: _______________________

Verification Performed By: _____________________ Date: __________

Verification Period: [e.g., 30 days, 90 days post-implementation]

Verification Results:

[Has the nonconformity been eliminated? Has the root cause been addressed? Is there evidence the problem will not recur?]

Effectiveness Confirmed:

• Yes - Corrective actions were effective; CAR can be closed
• Partially - Some improvement but further action needed
• No - Corrective actions were ineffective; additional analysis required

If not fully effective, what additional actions are needed?

[Describe follow-up actions and return to Section 5]

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Section 7: CAR Closure

Closed By (IMS Coordinator): _____________________ Date: __________

Closure Approval:

• Root cause properly identified
• Corrective actions address root cause
• All actions implemented
• Effectiveness verified
• Documentation updated
• Lessons learned captured

CAR Status: [ ] CLOSED [ ] OPEN - Further action required

Lessons Learned:

[What did we learn from this CAR? How can we apply this knowledge elsewhere?]

Communicated to: [Teams, forums, or individuals who should be aware of this learning]

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Notes for Users

When to Raise a CAR

Raise a CAR when you identify:

• Nonconformities: Situations where requirements (ISO standards, policies, procedures, customer requirements) are not met
• Near Misses: Situations that could have resulted in nonconformity (consider for preventive action)
• Recurring Issues: Problems that keep happening despite immediate fixes
• Audit Findings: Internal or external audit nonconformities

CAR vs. Improvement Suggestion

• CAR: Fixes something that went wrong (reactive)
• Improvement Suggestion (SW-IMS-FRM-002): Proactively enhances something that's working but could be better

Corrective Action vs. Immediate Action

• Immediate Action (Containment): Quick fix to control the immediate problem
• Corrective Action: Systematic fix that addresses the root cause to prevent recurrence

Example:

• Immediate: Manually send the customer their invoice
• Corrective: Fix the automated invoicing system and add monitoring

Root Cause Analysis Tips

• Don't stop too soon: Keep asking "why" until you reach a systemic issue
• Avoid blame: Focus on process/system failures, not individual mistakes
• Look upstream: Root causes are often in planning, design, or management—not execution
• Test your root cause: If you fix it, would the problem be prevented?

Priority and Timelines

Severity	Target for Corrective Action Plan	Target for Implementation
Critical	3 working days	10 working days
High	5 working days	30 working days
Medium	10 working days	60 working days
Low	15 working days	90 working days

Targets may be adjusted based on complexity and resource availability.

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Document Control

Version	Date	Author	Changes	Approved By
1.0	[TBD]	IMS Coordinator	Initial template creation	[TBD]

Next Review Date: [TBD]

Document Classification: Internal

Document Owner: IMS Coordinator