Pharmaceutical Supply Risk Assessment Form
Evaluate and document potential risks in your pharmaceutical supply operations.
Company Name
*
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Primary Supplier Name
*
Which risk areas are most relevant to your current supply operations?
*
Supplier reliability
Supply chain disruptions
Quality control issues
Regulatory compliance
Inventory management
Transportation/storage
Other
Describe any recent supply disruptions or delays and their causes.
What quality control measures are in place for incoming supplies?
How frequently do you review supplier compliance with regulations?
*
Please Select
Monthly
Quarterly
Annually
Only when issues arise
Not reviewed
Please rate your current level of supply chain risk.
*
Low
1
2
3
4
High
5
1 is Low, 5 is High
What mitigation strategies are currently implemented?
Additional comments or concerns regarding supply risk:
Submit Assessment
Should be Empty: