Document Change Request Log template
A log in the Control of Documents procedure (PR02), mapped to ISO 15189:2022 clause 8.3. Fill it in monthly. Used by the quality-management team.
LogISO 15189 · 8.3Monthly
Calculated automaticallyRed = outside limits
Your LaboratoryDocument Change Request Log | YL-QM-LOG-02-F04 v1.0
Record: Document Change Request Log — October 2026
Complete when a change is needed before the scheduled review and submit to the Quality Officer (PR02, 6.8.3). Record the reason for any rejection (PR02, 6.8.6).
| No. | Date | Requested by | Doc ID / version | Section affected | Proposed change | Reason | Decision | Reason if rejected | Decided by / date | New version / date issued |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2026-10-01 | T. Moyo | 2 | Haematology | Approved | 2026-10-01 | 2026-10-01 | |||
| 2 | 2026-10-08 | R. Naidoo | 2 | Chemistry | Approved | 2026-10-08 | 2026-10-08 | |||
| 3 | 2026-10-15 | S. Dlamini | 2 | Microbiology | Approved | 2026-10-15 | 2026-10-15 | |||
| 4 | 2026-10-22 | A. Mensah | 2 | Reception | Approved | 2026-10-22 | 2026-10-22 | |||
| 5 | 2026-10-29 | L. Banda | 2 | Haematology | Approved | 2026-10-29 | 2026-10-29 | |||
| 6 | 2026-11-05 | K. Otieno | 2 | Chemistry | Approved | 2026-11-05 | 2026-11-05 | |||
| 7 | 2026-11-12 | T. Moyo | 2 | Microbiology | Approved | 2026-11-12 | 2026-11-12 | |||
| 8 | 2026-11-19 | R. Naidoo | 2 | Reception | Approved | 2026-11-19 | 2026-11-19 |
Sign-off
| Role | Name | Signature | Date |
|---|---|---|---|
| Completed by | |||
| Reviewed by |
Shaded cells are calculated automatically. Values in red are outside their limits. † marks a corrected value (see Corrections).
Controlled document. Printed copies are uncontrolled unless stamped.Page 1
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What it records
- Date
- Requested by
- Doc ID / version
- Section affected
- Proposed change
- Reason
- Decision
- Reason if rejected
- Decided by / date
- New version / date issued
Instructions on the form
- Complete when a change is needed before the scheduled review and submit to the Quality Officer (PR02, 6.8.3). Record the reason for any rejection (PR02, 6.8.6).
Sign-off
- Completed by
- Reviewed by
Related templates
- Document Attestation Form (PR02-F02)
- Document Distribution and Retrieval Form (PR02-F03)
- Archiving and Removal Form (PR02-F05)
- Guide: ISO 15189 document control
- Guide: ISO 15189 documentation checklist
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.