Sample Project Scope Change Request
May 9, 2010If you or your project team is dealing with project scope creep, use this project scope change request form to gain some control. Simply ask your clients to fill out this form when requesting a change to the scope of the project. The form asks them to define the proposed change and allows them to see how a change can affect the project budget and scheduling. The completed form then serves as a clear-cut agreement between you and your clients on how the project is to proceed.
Project Title:
Project Number:
General Information
|
Change Request # Change Request Submitted By Submitter Phone E-mail Address Date Submitted Person Requesting Change Requester Phone Related Change Request Numbers |
Proposed Change
|
Detailed Description of Change
Reason for Change |
Impacts
| Background |
| Technical Impact |
| Budget Impact (cost and labor) |
| Schedule Impact |
| Performance Impact |
| Enterprise Impact (impact to other projects) |
| Other Impacts |
Project Team Review
|
Approved Denied Held Approved with Specified Conditions
Name Title/Role Project Manager Signature __________________________________ Date ________________ |
| Reason for Action |
| Attach supporting documents if necessary |
Director’s Review
| Approved Denied Approved with Specified Conditions Name Title/Role Signature __________________________________ Date ________________ |
| Reason for Action |
| Special conditions |