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TemplatePublished 10 Jul 2026Updated 14 Jul 20263 min readBy Kevin Joginchange managementchange requestsimple changeproject control
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Templates & Examples · Project Templates
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.

3 min read 3 sections Document Template Worked Example
Submit Assess PENDING Decision
Doc № KEV-TPL-097 Sec 4 Sheet 1/1 Drawn KEVOS® 10 Jul 2026

In this resource

  1. Purpose of the Simple Change Request
  2. Blank Template
  3. 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]
Category
Scope
Quality
Requirements
Cost
Schedule
Documents
Detailed Description of Proposed Change
[Provide a clear, specific description of exactly what is being requested. Define the boundaries of the change.]
Justification for Proposed Change
[Why is this change necessary or beneficial? What business value does it drive?]
Impacts (Summary)
[Briefly detail the assessed impacts on scope, cost, schedule, and quality.]
Disposition
Approve
Defer
Reject
Justification (CCB/PM)
(To be completed by CCB/PM during assessment)
Contents

§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
Category
Scope
Quality
Requirements
Cost
Schedule
Documents
Detailed Description of Proposed Change
Add LinkedIn profile icons to each consultant's bio card in the consultant directory. Each bio card would display a small LinkedIn icon that links to the consultant's public LinkedIn profile (URL supplied by the consultant).

Affects ~50 launch-tier consultant cards. Out of scope: any other social platforms; LinkedIn data scraping; sign-in-with-LinkedIn functionality.
Justification for Proposed Change
Marketing Lead reports that prospects researching consultants typically check LinkedIn profiles. Providing direct links from each bio reduces friction and reinforces credibility. Sales Lead supports current process requires prospects to search consultant names manually. Low-effort, high-perceived-value change.
Impacts (Summary)
Scope: +1 small element on bio card; +1 data field collected from consultants (LinkedIn URL).
Requirements: Adds F-08 LinkedIn-link display to RTM.
Cost: Estimated +$400 (Bob 4 hrs frontend; Christine 2 hrs to collect URLs from launch-tier consultants). Drawn from contingency.
Schedule: No critical-path impact. Work fits in existing build buffer.
Quality: No additional accessibility or performance concerns; LinkedIn icon is a well-understood pattern.
Disposition
Approve
Defer
Reject
Justification (CCB/PM)
(To be completed by CCB/PM during assessment)

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

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