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Project Name
Scope Change Request Form
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Prepared By: xxxxxxxxx

Date of Publication: mm/dd/yyyy

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 Add Project Name Here
Scope Change Request Form
Revision History

Version Date Author(s) Revision Notes

1.0 (Original author)

Copyright and Intellectual Property Statement

This template is the intellectual property of TenStep, Inc. It may be used and modified within the terms and
conditions of your TenStep, Inc. license agreement (Member, Browse, Consultant, etc.) Unauthorized use, sale,
resale, copying, etc. are strictly forbidden by USA and international copyright law. (Remove this comment section
from final document.)

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Copyright 2005 TenStep, Inc. All Rights Reserved
 Add Project Name Here
Scope Change Request Form

Larger projects need more rigor and structure in how they raise and manage scope change requests. The Scope
Change Request Form is used to capture, screen, prioritize, and evaluate scope change requests. Each form should
be used to describe one specific scope change request. Be sure to include enough information so that the request
can be identified and tracked, but not so much information that the form becomes a report. A summary of all open
and closed requests is kept in the Scope Change Log. (Remove this comment section from final document.)

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Copyright 2005 TenStep, Inc. All Rights Reserved
 Add Project Name Here
Scope Change Request Form

Project Name Scope Change Request Form

Scope Change Number: Requested By: Date Reported:

Scope Change Status: Scope Change Assigned To: Date Resolved:

Scope Change Description:

Business Benefit:

Implications of Not Making the Change:

Impact Analysis to the Project:

Alternatives:

Final Resolution:

Approval from Sponsor to Investigate (Optional):

Approval from Sponsor for Final Resolution:

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Copyright 2005 TenStep, Inc. All Rights Reserved