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To use this template for your project, click on Tools and choose "copy" or "export".

View Template Examples of this template.

1.0 Change Request Overview

1.1 Project Name:


1.2 Change Request #:


1.3 Change Name or Brief Description (high-level)


1.4 Requester:


1.5 Date Requested:


1.6 Current Status:


1.7 Priority and/or Need-By Date/Phase:

Critical, High, Medium or Low 

2.0 Description and Justification

2.1 Description of the Requested Change:


2.2 Benefit of the Change:

e.g. increasing or decreasing costs;
increasing or decreasing benefits;
increasing or decreasing risks

3.0 Impact Evaluation

3.1 Resource Plan Impacts

3.1.1 Estimate of Effort:


3.2.1 Are the skills required currently available on the team?


3.3.1 When would resources need to be available to begin the work?


3.2 Schedule Impact

3.2.1 Describe the impact to the current project schedule:


Milestone Phase

Current Completion Date

New Completion Date













3.3 Budget Impact



Resource Effort




4.0 Describe how the change will be accomplished

4.1 How will the change be accomplished?


4.2 How will the activities to support this change be incorporated into the current planned activities?


5.0 Decision & Approval

Decision Made:


Date of Decision:


Approved by: