Policy Change Request

This form is to request changes to the Laboratory's RPM. Be sure to complete all fields with asterisk. Direct questions to any RMC member, the RM Program Manager, or requirementsmgmt@lbl.gov.

Request Date*

Policy Title*

Submitter's Name (last, first)*

Policy Owner Name (last, first)

(if different from Submitter)

Name of Reviewing/Approving Manager (last, first)*

RMC Representative Name*

Select or enter value

INSTRUCTIONS

State the changes explicitly: Change FROM xxx, Change TO yyy. Be sure to provide any correct link addresses. For Periodic Reviews, be sure to review currency of driving requirements and implementing documents and be sure to indicate new Next Review date. Attach a markup if the changes are too lengthy to fit the box below.

State the changes to be made:*

If lengthy, OK to attach markup (track changes on).

Change "Effective Date" TO:

Unless specified, current effective date will remain unchanged.

Change "Next Review Date" TO:*

Specify the Next Review date. Default is: No Change. If this is a Periodic Review, then enter new Next Review date (typically - Publication date + 3 yrs maximum).

When do you want the change published?*

If publication has to be coordinated with other actions, give instructions below.

Do you have any additional instructions or comments?

For example, 30 day comment, timing with Elements notice.

Attachments

Significance Rating Form is mandatory for minor and major/new. Implementation Plan is mandatory for major/new and optional for minor. Markup of changes is preferred but optional.

Drag and drop files here or

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