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Practitioner template

Periodic Review Template

Determine whether current operational evidence continues to support the approved intended use and validated state.

Author
CSVtoCSA editorial
Published
12 September 2026
Last reviewed
2026-09-12
Version
1.0
Content type
Template
Primary references
Apply the sources and approved procedures relevant to the system
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Blank template

  1. System, scope, and review period
  2. Current intended use and configuration
  3. Changes and releases
  4. Incidents, deviations, and CAPA
  5. Access and audit-trail review
  6. Backup, restore, and continuity
  7. Supplier and service performance
  8. Open actions and evidence gaps
  9. Validated-state conclusion
  10. Next review or event trigger

Completed fictional example

Fictional teaching example: This is not an executed or approved validation record.

System, scope, and review period
Fictional LIMS interface; October 2025 through September 2026
Current intended use and configuration
Approved-result transfer to ERP; interface version 4.2
Changes and releases
Two mapping additions with approved targeted regression
Incidents, deviations, and CAPA
One delayed message; no incorrect material disposition
Access and audit-trail review
Service accounts and support roles remain approved
Backup, restore, and continuity
Queue recovery and record retrieval tested in May 2026
Supplier and service performance
No material SLA or platform control change
Open actions and evidence gaps
Improve aged-message alert ownership
Validated-state conclusion
Continued use is supported with the open action tracked
Next review or event trigger
September 2027 or earlier schema, mapping, or reconciliation change