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5 Whys Form Template

A 5 whys form template is used by business teams to drill down to the root cause of a problem using the 5 Whys technique. This template has been designed to make it easier for teams to ask and answer the question, “Why did this problem occur?” 5 times to discover the root cause. Take or attach relevant photos with the use of this template and complete this digitized 5 whys form with electronic signatures.
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Inspection
5 Whys
Indicate a recurring problem in the organization
WHY 1
Why did this problem occur?
Take/ attach relevant photos.
WHY 2
Why did this problem (why 1) occur?
Take/ attach relevant photos.
WHY 3
Why did this problem (why 2) occur?
Take/ attach relevant photos.
WHY 4
Why did this problem (why 3) occur?
Take/ attach relevant photos.
WHY 5
What is the root cause of the problem?
Take/ attach relevant photos.
What can be a solution to the root cause of the problem?
Completion
Additional Suggestions
Full Name and Signature of Team Leader
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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.
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