适用的偏差处理记录表格.doc
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偏差调查申请表
一、偏差情况概述：
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_________________________________________________________________________________
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申请人/日期：
______________________部门负责人/日期：
__________________
二、偏差调查申请的审批意见：
_________________________________________________________________________________
_________________________________________________________________________________
批准人/日期：
______________________
三、偏差调查编号为：
_________________________
偏差管理员/日期：
______________________
偏差调查表
偏差主题
偏差编号
一、偏差发现人员描述偏差状况：
1.人员1：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2.人员2：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
3.人员3：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
二、对于本偏差是否在发现后已采取了部分紧急纠正措施：
是□/否□（如已采取了措施，记录如下）
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
记录人/日期：
_______________确认人/日期：
_______________________
偏差调查表
（续表一）
偏差主题
偏差编号
三、各部门分析调查过程和结论：
1.部门1：
________分析人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2.部门2：
________分析人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
3.部门3：
________分析人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
四、对于本偏差是否召开了专题分析会议：
是□/否□（如召开了专题分析会议，会议内容记录如下）
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
记录人/日期：
________________________确认人/日期：
_______________________
偏差调查表
（续表二）
偏差主题
偏差编号
五、偏差调查过程中是否有附加检测项目：
是□/否□（如果有，记录如下）
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
记录人/日期：
________________________确认人/日期：
_______________________
六、偏差原因的最终判定和定性分类：
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
判定人/日期：
_______________________
七、针对本偏差还应采取的纠正措施建议：
1.部门1：
________提议人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2.部门2：
________提议人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
偏差调查表
（续表三）
偏差主题
偏差编号
八、针对本偏差应采取的预防措施建议：
1.部门1：
________分析人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2.部门2：
________分析人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
3.部门3：
________分析人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
4.部门4：
________分析人：
___________职务：
___________记录日期：
___________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
偏差调查表
（续表四）
偏差主题
偏差编号
九、确认本偏差还应采取的纠正措施：
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
确认人/日期：
_______________________
十、确认本偏差应采取的预防措施：
__________________________________________________________________________________
__________________________________________________________________________________
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