Optional Implementation Check List Changes, New Process or Procedure       Group Process is Located within P1000 P2000 P3000 P4000 P5000     Specific Process Process Name       Summary of Change       Responsibility     Process Owner Assisting Process Owner in Deployment Implementation Date     Change is a result of:   Corrective Action Preventive Action Continual Improvement         RLS Docs     Will this change affect the CHARTER (TOP SHEET RLS SERVER)? Yes No Is this change affecting the Flow Charts (RLS SERVER)? Yes No Will this change affect the measurements of the process (CHARTER/MATRIX)? Yes No     Summary:     Who Made the Changes?         Pilot     Pilot Changes? Yes No Length of Pilot Location of Pilot if Applicable         Training     How will Training Be Conducted Set up Curriculum in IVORY? Yes No Type of Training   One on One Roll Out Meeting Department Meeting Classroom     Date of Initial Training Trainer if Not Process Owner         Forms     Are forms changing or are new forms associated with this process needed? Yes No     If YES – Refer to Form F4002 for reprinting and changing forms.       Identify Person Implementing Forms Changes/Printing       IT/JJF SERVER     Are there changes that impact IT, RLS SERVER or programming? Yes No     Summary:       Primary Contact for IT Programming     Contact IT Director for any programming requests/changes.       Location Deployment     Specify Location where changes/processes apply and person responsible for deployment at location:     Area 1 Area 2 Area 3 Area 4 Area 5 Area 6 Area 7 Area 8 Area 9 REZ       Other Information Regarding Changes:    Form 4021 Rev. Date 01.22.10