Personnel Replacement Form template
A form in the Personnel, Training and Competence procedure (PR12), mapped to ISO 15189:2022 clause 6.2. Fill it in whenever the task occurs. Used by the quality-management team.
FormISO 15189 · 6.2As needed
Calculated automaticallyRed = outside limits
Your LaboratoryPersonnel Replacement Form | YL-QM-FRM-12-F12 v1.0
Record: Personnel Replacement Form — October 2026
Position Being VacatedMedical Technologist
Name of Departing StaffS. Dlamini
Reason for DepartureResignation
Last Date of Duty2026-10-01
Name of Replacement Staff (if identified)S. Dlamini
Replacement TypePermanent
Handover Items
| No. | Handover Item | Handed Over? (Y/N) | Date | Received by | Comments |
|---|---|---|---|---|---|
| 1 | Equipment access / passwords | Y | 2026-10-01 | S. Dlamini | Within limits |
| 2 | Patient records / accession registers | Y | 2026-10-08 | A. Mensah | |
| 3 | Pending test results | Y | 2026-10-15 | L. Banda | |
| 4 | Outstanding NC/CA records | N | 2026-10-22 | K. Otieno | Within limits |
| 5 | Equipment maintenance responsibilities | Y | 2026-10-29 | T. Moyo | |
| 6 | Ordering / inventory responsibilities | Y | 2026-11-05 | R. Naidoo | |
| 7 | IQC and EQA responsibilities | Y | 2026-11-12 | S. Dlamini | Within limits |
| 8 | Training responsibilities | Y | 2026-11-19 | A. Mensah | |
| 9 | Keys / access cards | Y | 2026-11-26 | L. Banda | |
| 10 | Y | 2026-12-03 | K. Otieno | Within limits | |
| 11 | Y | 2026-12-10 | T. Moyo |
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 11 of 11 rowsExactly as LabToolkit Pro prints it — with your logo and colours
What it records
- Handover Item
- Handed Over? (Y/N)
- Date
- Received by
- Comments
Sign-off
- Completed by
- Reviewed by
Related templates
- Personnel File Checklist (PR12-F01)
- Personnel Orientation Checklist (PR12-F02)
- Code of Ethics, Impartiality & Confidentiality Declaration (PR12-F03)
- Personnel Training & Continuous Professional Development Plan (PR12-F04)
- Training Evaluation Form (PR12-F05)
- Competence Matrix (PR12-F06)
- General Competence Assessment Form (PR12-F07a)
- Management System Training and Competence Form (PR12-F07b)
- Departmental Technical Training and Competency Assessment (template for F07c–F07i) (PR12-F07c)
- Competency Assessment Form (PR12-F08)
- Personnel Authorization Matrix (PR12-F09)
- Authorised Signatures & Initials Log (PR12-F10)
- Work Schedule (PR12-F11a)
- Departmental Duty Roster (PR12-F11b)
- On-call Roster (PR12-F11c)
- Guide: ISO 15189 documentation checklist
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.