Templates & Examples / Project Templates

Change Request (Simple)

A streamlined change request form template and worked example for proposing minor project modifications, shown pending formal assessment.

8 min read 3 sections Document Template Worked Example

Doc № KEV-TPL-097 Sec 4 Sheet 1/1 Drawn KEVOS® 10 Jul 2026

In this resource

Purpose of the Simple Change Request
Blank Template
Worked Example: Pending Assessment

§1 Purpose of the Simple Change Request

The Simple Change Request form provides a streamlined mechanism for proposing minor project modifications, bypassing the heavier documentation required for high-impact changes.

While large projects demand rigorous multi-criteria decision analysis for every change, many agile or fast-paced engagements benefit from a lighter touch. This template reduces the administrative burden by merging the core proposal and impact summary into a single page, designed for rapid assessment by the Project Manager (PM) or Change Control Board (CCB).

Pending State Example The worked example in this document demonstrates a change request that has been submitted and marked for approval by the requestor, but is currently sitting in a pending state awaiting the formal documented justification from the CCB/PM.

Contents

§2 Blank Template

A streamlined structure for capturing and assessing minor project changes.

CHANGE REQUEST

Project Title [Insert Project Name]

Date Prepared [YYYY-MM-DD]

Change Request ID [CR-###]

Requestor [Name and Role]

§3 Worked Example: Pending Assessment

A completed example demonstrating a minor scope addition currently pending formal assessment.

CHANGE REQUEST

Project Title Mary's Consulting - New Company Website

Date Prepared Oct 15, 2026

Change Request ID CR-008

Requestor Marketing Lead

Streamlined Intake

This simple format merges the proposal and impact analysis into a single flow, making it ideal for low-risk changes that don't require extensive MCDA scoring.

Pending State

Notice that the requestor has recommended "Approve", but the formal CCB/PM justification remains blank, reflecting a document currently under active assessment.

Clear Boundaries

Even on a simple form, the requestor explicitly states what is out of scope (data scraping, SSO) to prevent the minor addition from spiralling into a major feature.

Contents

Handbook application: from concept to controlled practice

Purpose. This expanded section turns the original page into a practical handbook. It preserves the supplied material and adds a repeatable way to apply, check and review Simple Change Request Form. It does not replace a contract, legislation, a controlled standard, competent engineering judgement or specialist advice.

The operating aim is to make the blank artefact usable by explaining what belongs in each field, who supplies it and how it is reviewed. Read the original explanation first, then use the workflow and checks below to convert knowledge into evidence.

Use Simple Change Request Form as a decision instrument rather than an administrative form. The subject terms—change, request, simple, template, example—need an explicit connection to the project objective, business value and stakeholder commitments. Before completing the artefact, write one sentence stating who will use it, what decision it supports and when that decision is required.

Apply a disciplined information model. Separate facts supported by evidence, forecasts derived from a method, assumptions awaiting validation, constraints that limit choice, risks that may occur, issues that already exist and actions assigned to people. Each material entry should have an owner, date, status and next review point. Where probability or impact scores are used, define the scale so different reviewers interpret it consistently.

A baseline is useful only when changes are visible. Give the artefact an identifier, version, approval state and effective date. Define which changes require reapproval, how superseded versions are retained and where supporting evidence is stored. During reviews, focus on exceptions, decisions and trends rather than reading every field aloud. Record the decision and rationale, not merely that a meeting occurred.

Close the loop beyond delivery. Confirm acceptance criteria, unresolved items, transferred responsibilities and operational ownership. Where benefits are expected, identify the outcome measure, baseline, target, observation period and owner who remains accountable after the project team disbands. Lessons should describe the condition, consequence and reusable action; a generic statement such as “communicate better” cannot improve the next project.

Step-by-step operating method

Name the decision. Write the decision, approval, handover or control activity the completed template must support.
Assign ownership. Nominate one accountable owner and identify contributors, reviewers and approvers.
Gather evidence. Use records, estimates, stakeholder input and source references rather than unsupported opinion.
Complete with discipline. Use consistent dates, units, identifiers, status values and version controls.
Review and maintain. Check completeness and logic, approve the baseline, then update it when trigger conditions occur.

Completion and governance protocol

Start with a short drafting workshop involving the accountable owner and the people who hold the evidence. Complete high-consequence fields first: objective, scope, owner, baseline, acceptance, dependencies and escalation. Mark unknowns as assumptions or actions rather than hiding them behind vague prose. Circulate a review draft, resolve conflicting interpretations, baseline the approved version and place the next review date in an owned schedule.

Information type	Minimum useful content	Review test
Outcome	Observable change and intended recipient	Not merely a deliverable or activity
Measure	Definition, baseline, target, frequency and source	Two reviewers would calculate it the same way
Ownership	One accountable role plus contributors and approver	Authority matches responsibility
Uncertainty	Assumption, risk or issue with response and trigger	Status reflects current reality
Control	Version, approval, review date and change rule	Current baseline is identifiable

Common failure modes and recovery actions

1. Watch for

Filling every box even when a field is not applicable instead of recording why.

Recovery: Return to the governing definition or requirement and restate the decision in one sentence.

2. Watch for

Writing vague statements without an owner, measure, date or evidence source.

Recovery: Separate evidence from assumption, assign an owner and set a date for validation.

3. Watch for

Copying a previous project without revalidating assumptions and stakeholders.

Recovery: Run a small counterexample, boundary test, pilot or independent check before proceeding.

4. Watch for

Using the document as a private worksheet when it is meant to support a shared decision.

Recovery: Record the consequence, decision and rationale, then update the controlled baseline.

5. Watch for

Creating an approved baseline but failing to define who maintains it and when.

Recovery: Escalate when the issue affects safety, compliance, acceptance, material value or an agreed tolerance.

Review checklist

Is the purpose and intended decision clear to a reader outside the team?
Are owners, dates, measures and sources complete and internally consistent?
Which fields are assumptions and how will they be validated?
What event, threshold or review date causes this document to change?
Are mandatory requirements distinguished from recommendations and illustrative values?
Are sources, assumptions, units, dates and versions recorded closely enough to reproduce the decision?
Have safety, legal, ethical, stakeholder and operational consequences been considered at the appropriate level?
Is there a named owner and a trigger for review, escalation, change or retirement?

Questions for deeper application

What is the most important distinction a practitioner must preserve when applying Simple Change Request Form?