CORRECTIVE ACTION REVIEW FORM Form: FM_MQL24 To be completed by the AUDITOR and submitted to the MANUFACTURER and the APVMA, within 10 days of receipt of Corrective Actions/Plan submitted for Desk Review or date of Verification Audit. Email: Post: Fax: (preferred) APVMA (02) 6210 4813 PO Box 6182 KINGSTON ACT 2604 Name and street Licence / address Reference of Manufacturer No. audited. Desk Review Date/s of original Review Date: ……….. audit. Type Verification Audit Date: ……….. Name Auditor’s Corrective Action Review: NC No. Plan (where approved by APVMA) or Satisfactory If, Date Rec’d “No”, Evidence Reviewed from Manuf. (Yes/No) Due Date (from (desk review for Section C of (please confirm why proposed plan for corrective actions has submissions) Audit been accepted or specify document numbers etc when /Re-Audit Report) undertaking a review of objective evidence, attach copy of corrective action plan, if applicable)
CORRECTIVE ACTION REVIEW FORM Form: FM_MQL24 To be completed by the AUDITOR and submitted to the MANUFACTURER and the APVMA, within 10 days of receipt of Corrective Actions/Plan submitted for Desk Review or date of Verification Audit. Email: Post: Fax: (preferred) APVMA PO Box 6182 KINGSTON ACT 2604 (02) 6210 4813 Name and street address of Manufacturer audited. Licence / Reference No. Date/s of original audit. Review Type Desk Review Date: ……….. Verification Audit Date: ……….. Auditor’s Name Corrective Action Review: NC No. (from Section C of Audit Report) Plan (where approved by APVMA) or Evidence Reviewed (please confirm why proposed plan for corrective actions has been accepted or specify document numbers etc when undertaking a review of objective evidence, attach copy of corrective action plan, if applicable) Date Rec’d from Manuf. (desk review submissions) Satisfactory (Yes/No) If, “No”, Due Date for /Re-Audit
fm-mql24-corrective-action-review-form.docx