Media Plan Change Audit Trail Log Form
Log and review all changes made to media plans or campaigns for audit and compliance purposes.
Change Request Identifier
*
Date and Time of Change
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Requester Full Name
*
First Name
Last Name
Department or Team
*
Please Select
Marketing
Media Buying
Creative
Analytics
Account Management
Other
Media Plan or Campaign Name
*
Change Type
*
Please Select
Budget Adjustment
Channel Addition/Removal
Creative Update
Schedule Change
Targeting Modification
Other
Affected Channels or Assets
*
TV
Radio
Digital Display
Social Media
Print
Out-of-Home
Other
Description of Requested Change
*
Reason for the Change
*
Impact Assessment
Approval / Verification Status
*
Pending
Approved
Rejected
Needs Review
Auditor / Reviewer Notes
Submit Audit Log
Should be Empty: