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Catalog · Forms

CAPA Request & Record Form

A single-record CAPA form that carries one issue from initiation through effectiveness check — each block capturing exactly the evidence ISO 13485 §8.5.2 expects a record to show.

DOCX template6 record blocksCompanion to RT-SOP-007 CAPA procedure
  • File one form per CAPA and have the whole story — problem, cause, action, effectiveness — in one auditable record
  • Stop losing effectiveness checks: the form carries the check as a block that must be completed before disposition
  • Hand auditors a record whose blocks match the procedure's steps one-for-one
What's inside

Built like the working documents we write about

  • Record details block

    CAPA number, source, dates and risk priority — the fields your log and trending run on.

  • Problem statement

    A structured statement of what was found, where, and what product or process is affected.

  • Investigation and root cause

    Method used, evidence examined, and a root-cause statement that has to explain the nonconformity, not restate it.

  • Action plan

    Actions tied to the root cause with owners and due dates — document, training and validation impacts prompted.

  • Effectiveness check

    Defined interval, defined evidence, recorded result — the step FDA inspections most often find missing.

  • Review and disposition

    Quality's closure decision with signature and date — the record ends the way §8.5.2 expects.

The source map

Why each section exists

Bundle shops sell you a zip and a wish. Every section of this document states the clause it was written to satisfy — the same map is printed inside the document, where your auditor can read it.

Document sectionSatisfies
Record detailsISO 13485 §8.5.2(a) · nonconformity review starts as a record, with source and priority
Problem statementISO 13485 §8.5.2(a) · determining the nonconformity, stated verifiably
Investigation and root causeISO 13485 §8.5.2(b) · determining causes with a structured method
Action planISO 13485 §8.5.2(c)–(d) · evaluating need and planning proportionate action
Effectiveness checkISO 13485 §8.5.2(f) · reviewing effectiveness with objective evidence
Review and dispositionISO 13485 §4.2.5 · the completed form is a controlled quality record
Whole documentFDA QMSR (21 CFR 820, eff. 2026-02-02) · incorporates ISO 13485:2016 by reference
The details

Exactly what you get

No surprises at download time — the format, the scope, and the license, stated up front.

Format
Microsoft Word (.docx) — no macros, works in Google Docs
Length
6 record blocks · signature and disposition fields included
Mapped to
ISO 13485:2016 §8.5.2 and §4.2.5 (records), block by block
Works with
RT-SOP-007 CAPA Procedure and RT-LOG-001 CAPA Log — referenced by number in the procedure's §3
Delivery
Instant download after checkout, with a re-download link on your receipt
Updates
Revised when the source moves; buyers get the new revision by email, free
License
One purchase covers your team at one company site

Check our work

A form is where a CAPA system succeeds or quietly fails — the blocks decide what evidence exists at audit time. Read the craft behind it: what a complaint record has to decide before it becomes a CAPA and what a CAPA tracker has to track.

Take the form template to work today.

One purchase, yours immediately at launch — and revised for free when the source moves.