Change Request Template

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 

2.1 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

3.1.1 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?

3.2.1 Describe the impact to the current project schedule:

Resource Effort

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?

Decision Made:

Date of Decision:

Approved by: