Document no.
: CAPA-REG-001
CAPA form
Version: 0
Owner: Approved by: Effective date: 2025-08-20
Date: Date:
Input for Corrective/Preventive action
Notified Body: Complaints: Other: ________ Ref.: Date:
Description of issue triggering the CAPA:
Scope
CAPA to relate to product or quality system?
Date: Completed by:
Root Cause / Investigation
Date: Completed by:
Risk Assessment
Risk and Impact assessment:
Date: Completed by:
Immediate Correction
Describe the immediate actions taken:
Date: Completed by:
Corrective Action/Preventive Action
Responsible: Q responsible:
Description of corrective and preventive action / Action Plan:
Date: Completed by:
Verification of Corrective/Preventive action
Responsible for verification:
Describe what to verify / verification method:
Date: Completed by:
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