Copyright Red Engine Consulting 2009-2010 Page 1
REQUEST FOR CHANGE FORM(RFC FORM)
Change Request
Number:
RFC
Date of Submission
Requestor Person submitting the RFC Phone: (000)000-0000
For Requestor's name if not self Phone: (000)000-0000
Backup contact Enter BACKUP'S name Phone: (000)000-0000
All fields must be filled out completely. Incomplete RFCs will be returned.
Does the entire change stand on its own? If there is an implementation plan, can some
of the steps be implemented or backed out together? If some steps can remain though
others fail, the Request for Change (RFC) should be broken down into individual
RFCs.
Field 1: Brief Description (80 chars max)
Field 2: Detailed Description What the change is intended to accomplish, why it is necessary,
and what will happen if the change is NOT executed. (80 Chars max)
Field 3: Type of Change Check all subsystems that apply
Type of Subsystem Hardware Software Config Setup
Host
Network
Storage
Application
Database
Environment/ Facilities
Firewalls (attach Firewall
RFC Form)
OTHER - describe
subsystem
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Field 4: Reason for Change Check all that apply
TITLE Reason Reason Reason
Maintenance Preventative Corrective Other
Capacity Install Upgrade Swap/Reconfig
Functionality
/Service
New Expanded Obsolete
Testing Functionality Stress Recovery
Security Preventive Corrective Other
Other (Identify)
Field 5: Potential Impacts Describe overall impact:
Known/ Best Case
Impacts
Worst Case
Impacts
Affected Location
And/or Service Name
Production
Stage
Development
Test
Internet/External
Field 6: Production Outages: Expected duration
Hours: Minutes:
Field 7: Affected Host Names and Applications
Field 8: Change Type Select one.
Normal
Standard - Pre-Authorized (Original Change Request Number - RFC )
Emergency
Information Only
Host Name Application
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Field 9: Schedule Information
Implementation Group/
Representative
Day, Date
Time of Day
Duration of Implementation
: AM PM
Days Hours Minutes
Target Date(s)
Alternate Date(s)
Implementation Location
Related or Pre-requisite change
activities:
Field 10: Implementation Steps What steps are required to implement the change?
1.
2.
3.
4. 4)... (if necessary)
Field 11: Affected Documentation What databases or documentation need to be updated
prior to the completion of this change?
Field 12: Is this an Emergency Change?
Yes
No
If this is an Emergency Change, can the change be backed out in its entirety? Or, is a
partial back-out possible? Back-out Plan provided?
If this is an Emergency Change, please explain the emergency.
Field 13: Acceptance Criteria What tests will be used to confirm successful implementation?
Test Describe
Field 14: Backout Contingency Plan If the acceptance criteria are not met, what steps will be
performed to backout the change?
1.
2.
3.
4. (if needed)
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Field 15: Backout Criteria When the backout steps are performed, what tests will be used to
confirm successful backout?
Test Describe
Field 16: Escalation Plan If the backout criteria are not met, what method will be used to
escalate and resolve the problem?
1.
2.
3.
4. (if necessary)
Field 17: Other Considerations/Issues
Prior History
Special notification or
visibility
Helpdesk symptoms or
concerns
Field 18: CMDB Which Configuration Items (CIs) have been updated?
Configuration Item (CI) Name(s) and related Information:
Field 19: Related Request for Change Is this change related to other RFCs?
Please provide related RFC numbers:
Copyright Red Engine Consulting 2009-2010 Page 5
Field 20: Change Advisory Board Approvals
Problem Management
Yes
No
Comments:
Configuration Management
Yes
No
Comments:
Change Management
Yes
No
Comments:
Operations Management
Yes
No
Comments:
Security Management
Yes
No
Comments:
System Owner
Yes
No
Comments:
Others as Required
Yes
No
Comments:
