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PRELIMINARY EVALUATION FORM |
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This form is to be used to provide the information necessary for QSI to develop a proposal for management system certification. Please answer the questions below; considering only those areas and activities of the organization that would fall within the scope of the certification sought. |
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| * Legal Name of the Organization |
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| * Address |
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| * City |
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| * State/Province |
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| * Postal Code |
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| * Country |
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| * Phone |
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| Mobile Phone |
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| * Email |
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| Fax |
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| Website |
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| * Total Employees |
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* required fields
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Please select the standards to which your organization seeks certification: |
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| ISO 9001 - Quality Management |
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| ISO 13485 - QMS for Medical Devices |
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| ISO 14001 - Environmental Management |
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| OHSAS 18001 - Health and Safety Management |
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| ISO 22000 - Food Safety Management |
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| ISO 20000 - Technology Service Management |
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| ISO 27001 - Information Security Management |
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| ISO 28001 - Security Management |
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| ISO 50001 - Energy Management |
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Please define the Certification Scope |
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| * Please describe the activities to be included. |
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| * Please list and explain any exclusions.
If there are none please type "NONE" |
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| Is this a multi-site certification? |
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| * Number of Sites |
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| Number of Employees @ Principal Site |
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| Number of Employees @ Largest Site |
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| Number of Employees @ 2nd Largest Site |
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| Number of Employees @ Smallest Site |
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| Number of Employees @ 2nd Smallest Site |
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| Average Number of Employees - All Sites |
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| Please lists the countries where the above sites are located: |
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Planning and Preparation Details |
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| * Approx. Date for the Stage 1 Certification Audit (mm-dd-yyyy) |
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| * Approx. Date for the Stage 2 Certification Audit (mm-dd-yyyy) |
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| * Will an (optional) Initial Review/Pre-Assessment be required? |
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| * Has a Policy Manual been issued? |
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| * Has a complete Internal Audit been conducted? |
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| * Has a complete Management Review been conducted? |
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Management Representative Information |
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| * Name of Management Rep. |
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| * Position |
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| * Phone |
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| * Email |
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| Additional Comments |
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* required fields
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| RBP |
If you were referred by a Regional Business Partner select their code below; otherwise select 999. |
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Note: To avoid an error message proper values must be entered in the required fields. If an error message is obtained please hit back on your browser to retain the information entered. |