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Introduce business developments with a change management plan template

This management of change form (MOC) must be signed by all responsible persons to confirm the approval of the changes to be implemented. Safety representatives can adapt this template to include a documentation list required for the safe implementation of changes.
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Management of Change
Information
Initiator of proposed change
Discription of suggested change
Area of Change
Suggested Date and Time to implement Change?
MOC Form
Does the involved personnel (e.g. operations, maintenance, contractors, etc.) require notification or training associated with this change?
Are operating or maintenance procedures required to be updated as a result of this change?
Does P&ID or other drawings need updating based on change?
Is the Offsite Consequence Analysis, PHA or Emergency Response Procedures impacted by this Change?
Does the Process Safety Information require updating as a consequence of this change?
If the change includes new equipment, have the Mechanical Integrity and testing inspection requirements been updated accordingly
Other impacts to this Process? (if Yes, list on notes)
Are training and communications completed?
Was Pre-Startup Safety Review (PSSR) completed with this change?
Are any other actions required as part of this change?
Completion of MOC
Further comments
Operations/Facility: Full name and signature
Building Facility: Full ame and signature
Area Supervisor: Full name and signature
Bldg. or Utility Operations Engr: Full name and signature
Safety Officer: Full name and signature
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Implement Change Effectively with our Management of Change Form


Change is an inevitable part of any business, but it must be managed carefully to avoid negative impacts. Our Management of Change Form streamlines the process by allowing you to assess and manage potential risks associated with change.


The form includes sections for identifying the change, evaluating the impact, and assessing the risks. It also includes a section for identifying potential mitigation measures to address any risks identified.


By using our Management of Change Form, you can ensure that change is implemented in a controlled manner, with risks identified and addressed before implementation. This reduces the potential for negative impacts on the business and allows for a smoother transition to the new way of doing things.

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.