PROJECT CHANGE REQUEST FORM - Fill out, analyze, and decide

Sep 12, 2026

Upload by Ezra

Project Change Request Form provides a structured workflow for submitting, reviewing, and deciding on proposed project changes. The template captures requestor information, change description and justification, referenced supporting documentation, impacts of not implementing, and priority selection. It also includes sections for initial review results and detailed impact analysis across schedule, scope, budget, quality, resources, design/testing/transition, configurations, risks, alternatives, and dependent effects. A final decision section records approval, denial, or deferral details, dates, and signatures.

LanguageEnglish

CategoryForms

FormatPDF

Pages4

Reading Time2 min

AccessFree to download

Part 1. Requestor Information

Change request details

Priority and requested by

Part 2. Analysis and Review

Results of initial review

Impact analysis

Part 3. Impact analysis continuation

Configuration items and risks

Part 4. Proposed Action

Approval, denial, or deferral

Part 5. Final Decision

Final approval record

PROJECT CHANGE REQUEST FORM Sample for Evaluation Only Create links to referenced documents (e.g., Link_To …): use Insert 􀃎 Hyperlink on your toolbar. Refer to the Change Control Plan for instructions on how to use this document. Part 1. Requestor Information Requestor: Fill in this page only. Enter appropriate information or place an “X” next to those that apply. Create links to any supporting documentation. Send your request to the Project Manager or other designated person. | 1. Change Request | | | --- | --- | |

Project

Name: | | |

Describe the

change 􀀉: | | |
Describe how this is justified: | | | Hyperlinks: | Link_To_Supporting_Document1
Link_To_Supporting_Document2 | |
Impact of Not Implementing Proposed Change: | | |

Alternatives

􀀉: | | |

Other

comments: | | | Priority: (check one) High [ ] Medium [ ] Low [ ]
| | |

Requested

by: | | |
| | Part 2. Analysis and Review | CR No. (enter in CR Log): | | | --- | --- | | 2. Results of Initial Review | | | | | | --- | --- | --- | --- | --- | | Initial Review Date:
(MM/DD/YYYY) | | | Performed by: | | |
Action Comments

Approve for Impact Analysis [ ]
Reject [ ]
Defer Until (MM/DD/YYYY) [ ]
Express Approval 􀀉: [ ] | | | | | | Analyst assigned for further analysis: | | | | | | Comments: | | | | | | 3. Impact Analysis | | | | | --- | --- | --- | --- | | Date of Analysis:
(MM/DD/YYYY) | | Performed by: | | | Area of Change: | | | | |
Scope [ ] Schedule [ ] | | | | |
Budget [ ] Quality [ ] | | | | |
Resources [ ] | | | | |
Is this Change the result of a Risk Management Action? 􀀉: | | | | |
No [ ] Yes [ ] Risk ID
􀀉: | | | | | Describe the impact for each item below. If no impact enter “none” | | | | |
Design 􀀉: | | | | |
Testing 􀀉: | | | | |
Resources 􀀉: | | | | |
Budget: | | | | |
Schedule: | | | | |
Quality: | | | | |
Transition 􀀉: | | | | | 3. Impact Analysis | | --- | |
Configuration Items 􀀉: | |
Describe Rework Required: | |
Describe New Work Required: | |
Project risk associated with implementing the change 􀀉: | |
Project risk associated with not implementing the change 􀀉:: | |
Risk to Business Value 􀀉: | |
Alternatives to the proposed:
change: | |
Impact on dependent projects 􀀉: | |
Impact on project baselines 􀀉: | |
Other impacts: | |
Comments : | |
Name of Analyst : | |
Date of Analysis (MM/DD/YYYY) : | This template is a sample from the CVR/IT Consulting LLC Template Library. Portions of this template have been made unreadable. To obtain a fully functional version of this template, [visit www.cvr-it.com](visit www.cvr-it.com) | 4. Proposed Action | | --- | | Select one: Approve [ ] Deny [ ] Defer [ ] until date:
| |
Details of proposed action: | |
Proposed by : | |
Date (MM/DD/YYYY) : | | Priority: (check one) High [ ] Medium [ ] Low [ ] | |
Signature: | | 5. Final Decision | | --- | | Select one: Approve [ ] Deny [ ] Defer [ ] until date:
| |
Decision details (if any): | |
Decision by : | |
Decision Date (MM/DD/YYYY) : | | Priority: (check one) High [ ] Medium [ ] Low [ ] | |
Signature: | This template is a sample from the CVR/IT Consulting LLC Template Library. Portions of this template have been made unreadable. To obtain a fully functional version of this template, [visit www.cvr-it.com](visit www.cvr-it.com)

FAQs

What information must the requestor provide in Part 1?

Part 1 collects the project name, a clear description of the change, justification, hyperlinks to supporting documents, the impact of not implementing the change, alternatives, other comments, requested priority, and who requested the change.

How does the form assess change impacts?

The template includes an impact analysis section covering schedule and scope, budget, quality, resources, design, testing, transition, configuration items, rework/new work, and impacts on business value and dependent projects.

How are risks and alternatives recorded?

The form asks for whether the change results from risk management actions, the risk ID, descriptions of risks associated with implementing or not implementing the change, risk to business value, and alternatives to the proposed change.

Sep 12, 2026

Upload by Ezra