QSI Certification Service Management – Pre-Evaluations

This application form is to be used to provide the information necessary for QSI to assess the scope of your certification serviced needs prior to developing a proposal for management system, process, service or product 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.

PRELIMINARY EVALUATION FORM
* Legal Name of the Organization
* Address
* City
* State/Province
* Postal Code
* Country
* Phone
Mobile Phone
* Email
Fax
Website
* Total Employees
Please select the standards to which your organization seeks certification
ISO 9001 – Quality Management
ISO 13485 – QMS for Medical Devices
ISO 14001 – Environmental Management
ISO 18788 – Management system for private security operations
ISO 22000 – Food Safety Management
ISO 20000 – Technology Service Management
ISO 27001 – Information Security Management
ISO 28001 – Security Management
ISO 50001 – Energy Management
ISO 45001 – Occupational health and safety
ISO 29990 – Learning services for non-formal education and training
QSI-ESAS – Automotive Safety
QSI – ISO 26001
Please define the Certification Scope
* Please describe the activities to be included.
* Please list and explain any exclusions.

If there are none please type “NONE”

Is this a multi-site certification?
* Number of Sites
Number of Employees @ Principal Site
Number of Employees @ Largest Site
Number of Employees @ 2nd Largest Site
Number of Employees @ Smallest Site
Number of Employees @ 2nd Smallest Site
Average Number of Employees – All Sites
Please lists the countries where the above sites are located:
Planning and Preparation Details
* Approx. Date for the Stage 1 Certification Audit
(mm-dd-yyyy)
* Approx. Date for the Stage 2 Certification Audit
(mm-dd-yyyy)
* Will an (optional) Initial Review/Pre-Assessment be required?
* Has a Policy Manual been issued?
* Has a complete Internal Audit been conducted?
* Has a complete Management Review been conducted?
Purchase Order Number
Management Representative Information
* Name of Management Rep.
* Position
* Phone
* Email
Additional Comments
RBP If you were referred by a Regional Business Partner select their code below; otherwise select 999.

* required fields

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