Nonconformity & Corrective Action Form template
A form in the Nonconformity and Corrective Action procedure (PR07), mapped to ISO 15189:2022 clauses 7.5, 8.7. Fill it in whenever the task occurs. Used by the quality-management team.
FormISO 15189 · 7.5, 8.7As needed
Calculated automaticallyRed = outside limits
Your LaboratoryNonconformity & Corrective Action Form | YL-QM-FRM-07-F01 v1.0
Record: Nonconformity & Corrective Action Form — October 2026
NC Reference No. (QO assigns)NC-26-001
Date Identified2026-10-01
Section / Process AffectedHaematology
Identified byR. Naidoo
Source of NCIQC Failure
Description of NonconformityMonthly QC review
Immediate Action TakenNone required
Risk Assessment
Root Cause (5-Why / Fishbone)
Corrective Action PlanNone required
Responsible Person (CA)S. Dlamini
Effectiveness Verification Method
Verification Result / Evidence5.06
NC StatusClosed-Effective
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
A4 portrait · first page · showing 0 of 0 rowsExactly as LabToolkit Pro prints it — with your logo and colours
What it records
- NC Reference No. (QO assigns)
- Date Identified
- Section / Process Affected
- Identified by
- Source of NC
- Description of Nonconformity
- Immediate Action Taken
- Root Cause (5-Why / Fishbone)
- Corrective Action Plan
- Responsible Person (CA)
- Effectiveness Verification Method
- Verification Result / Evidence
- NC Status
Sign-off
- Completed by
- Reviewed by
Related templates
- Corrective & Preventive Action (capa) Form (PR07-F01 (CAPA-FORM))
- Nonconformity Log (PR07-F02)
- CAPA Register & Status Tracker (PR07-F02 (CAPA-LOG))
- 5-why Root Cause Analysis Worksheet (PR07-F03a)
- Fishbone / Ishikawa Cause Analysis Worksheet (PR07-F03b)
- Failure Mode & Effect Analysis (fmea) Worksheet (PR07-F03c)
- CAPA Effectiveness Review Form (PR07-F04)
- Nonconformity Trend Analysis Dashboard (PR07-F05)
- Guide: ISO 15189 documentation checklist
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.