Change Request & Maintenance Window Form

1. Change Request Information

Change Request ID
Change Title
Requested By	Name: _______________ Email: _______________ Phone: _______________
Request Date
Change Type	☐ Standard ☐ Normal ☐ Emergency
Change Category	☐ Patch/Update ☐ Configuration ☐ Infrastructure ☐ Other: _______________

2. Business Justification

Reason for Change

_________________________________________________________________________________

Expected Benefits

_________________________________________________________________________________

Risk if Change Not Implemented

_________________________________________________________________________________

3. Technical Details

Affected System(s)	☐ PRD ☐ QAS ☐ DEV ☐ Other: _______________
System ID(s)
Component(s) Affected	☐ SAP Application ☐ Database ☐ OS ☐ Network ☐ Other: _______________
Detailed Description	_________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________

4. Impact Assessment

System Downtime Required

☐ Yes, estimated duration: _______________ ☐ No, online change possible

User Impact

Number of users affected: _____________

Business processes affected:

_________________________________________________________________________________

Integration Impact

Interfaces affected:

_________________________________________________________________________________

Risk Level

☐ Low ☐ Medium ☐ High ☐ Critical

Risk justification:

_________________________________________________________________________________

5. Implementation Plan

Implementation Steps	1. _____________________________________________________________________ 2. _____________________________________________________________________ 3. _____________________________________________________________________ 4. _____________________________________________________________________ 5. _____________________________________________________________________
Estimated Duration	_____ hours (from _______ to _______)
Implementation Team	Lead: _______________ Members: _________________________________________________________________
Non-Prod Testing Status	☐ Tested in DEV on _______________ Result: _______________ ☐ Tested in QAS on _______________ Result: _______________ ☐ Not tested (Emergency change)

6. Rollback Plan

⚠ REQUIRED: All production changes must have a documented rollback procedure.

Rollback Procedure	1. _____________________________________________________________________ 2. _____________________________________________________________________ 3. _____________________________________________________________________ 4. _____________________________________________________________________
Rollback Duration	_____ hours
Rollback Decision Criteria	Change will be rolled back if: _________________________________________________________________________ _________________________________________________________________________
Rollback Authority	Name: _______________ Phone: _______________
Decision Timeline	Go/No-Go decision must be made within _____ minutes of completion

7. Validation Plan

Validation Steps	1. _____________________________________________________________________ 2. _____________________________________________________________________ 3. _____________________________________________________________________ 4. _____________________________________________________________________
Success Criteria	_________________________________________________________________________ _________________________________________________________________________
Validation Owner	Name: _______________ Role: _______________

Validation Steps

1. _____________________________________________________________________

2. _____________________________________________________________________

3. _____________________________________________________________________

4. _____________________________________________________________________

Success Criteria

_________________________________________________________________________

Validation Owner

Name: _______________ Role: _______________

8. Maintenance Window Request

Proposed Date	_______________ (Day: ☐ Weekday ☐ Weekend)
Start Time	_______________
End Time	_______________
Alternative Date	_______________ (in case primary date not approved)
Change Freeze Check	☐ Confirmed: Not during month-end, quarter-end, or business critical period ☐ Exception required - Justification: _____________________________________

9. Communication Plan

Stakeholders to Notify	_________________________________________________________________________ _________________________________________________________________________
Notification Timeline	☐ 5 business days advance notice sent on: _______________ ☐ 24 hours reminder sent on: _______________ ☐ Start notification: _______________ ☐ Completion notification: _______________

Stakeholders to Notify

_________________________________________________________________________

Notification Timeline

☐ 5 business days advance notice sent on: _______________

☐ 24 hours reminder sent on: _______________

☐ Start notification: _______________

☐ Completion notification: _______________

10. Approvals

Technical Review	Name: ____________________ Role: ____________________ Signature: ____________________ Date: __________ ☐ Approved ☐ Approved with conditions ☐ Rejected Comments: _________________________________________________________________
Change Manager	Name: ____________________ Role: ____________________ Signature: ____________________ Date: __________ ☐ Approved ☐ Approved with conditions ☐ Rejected Comments: _________________________________________________________________
Business Owner	Name: ____________________ Role: ____________________ Signature: ____________________ Date: __________ ☐ Approved ☐ Approved with conditions ☐ Rejected Comments: _________________________________________________________________

Technical Review

Name: ____________________ Role: ____________________

Signature: ____________________ Date: __________

☐ Approved ☐ Approved with conditions ☐ Rejected

Comments: _________________________________________________________________

Change Manager

Name: ____________________ Role: ____________________

Signature: ____________________ Date: __________

☐ Approved ☐ Approved with conditions ☐ Rejected

Comments: _________________________________________________________________

Business Owner

Name: ____________________ Role: ____________________

Signature: ____________________ Date: __________

☐ Approved ☐ Approved with conditions ☐ Rejected

Comments: _________________________________________________________________

11. Post-Implementation

Actual Start Time
Actual End Time
Change Status	☐ Successful ☐ Successful with issues ☐ Rolled back ☐ Failed
Validation Results	_________________________________________________________________________ _________________________________________________________________________
Issues Encountered	_________________________________________________________________________ _________________________________________________________________________
Lessons Learned	_________________________________________________________________________ _________________________________________________________________________

Remova Inc. | www.removateam.org | notifications@removateam.org
This template is provided as a guide. Adapt as needed for your specific change management process.