Quality Assurance Complaint Evaluation Checklist
Use this checklist to comprehensively evaluate and document product or service complaints in a QA context.
Complaint Reference Number
*
Date Complaint Received
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Product or Service Involved
*
Complainant Name or Department
Complaint Description
*
Severity Assessment
*
Low
Moderate
High
Complaint Validity
*
Valid
Partially Valid
Not Valid
QA Process Checklist (select all that apply)
Complaint logged in system
Initial assessment completed
Root cause analysis performed
Corrective action identified
Resolution communicated to complainant
Follow-up scheduled
Overall Outcome/Status
*
Please Select
Resolved
Pending Investigation
Escalated
Closed - No Action Needed
Reviewer Comments
QA Reviewer Name
*
Submit Evaluation
Should be Empty: