Product Recall Closure Checklist Form
Use this form to document the completion, verification, and final closure status of a product recall.
Recall Identification
Recall / Reference Number
*
Product Name
*
Product SKU / Model / Lot / Batch Number
*
Recall Initiation Date
*
 -
Month
 -
Day
Year
Date
Responsible Department / Team
*
Please Select
Quality Assurance
Regulatory Affairs
Operations
Manufacturing
Supply Chain
Customer Support
Other
Closure Form Completion Date
*
 -
Month
 -
Day
Year
Date
Affected Product and Distribution Details
Affected quantity
*
Affected locations/markets
*
North America
South America
Europe
Asia-Pacific
Middle East & Africa
Online
Other
Distribution channels impacted
*
Retail stores
Wholesale
E-commerce
Direct sales
Distributors
Export partners
Other
Have all affected units been accounted for?
*
Yes
No
Partially
Closure Checklist and Corrective Actions
Recall communications to customers/distributors
*
Complete
In progress
Not started
Not applicable
Return/retrieval completion status
*
Complete
In progress
Not started
Not applicable
Quarantine/segregation status
*
Complete
In progress
Not started
Not applicable
Corrective action implementation status
*
Complete
In progress
Not started
Not applicable
Effectiveness verification status
*
Complete
In progress
Not started
Not applicable
Internal approvals complete
*
Quality
Regulatory
Operations
Legal
Other
Final Disposition and Confirmation
Final disposition method
*
Destroyed
Returned to supplier
Reworked
Relabeled
Other
Disposition completion date
*
 -
Month
 -
Day
Year
Date
Remaining open issues or exceptions
Follow-up action owner
*
Internal comments or notes
Submit
Should be Empty: