Root Cause Analysis Form Template
A free root cause analysis form for quality, safety and operations teams. Work through the 5 whys, name the root cause and assign corrective actions.
Customize the pages and design to fit your needs.
About this template
Describe the problem and its impact, ask why until you reach the real cause, and sort causes by people, methods, machines and materials. Finish with corrective actions, owners, due dates and how you'll check the fix.
Common uses
- Quality defects and customer complaints
- Safety incidents and near misses
- Equipment breakdowns and downtime
Key features
- 5 whys and cause categories
- Corrective actions with owners
- Photo and document uploads
What this template asks
What's your name?
Short Text
What's your work email?
Email
What problem are you investigating?
Short Text
What type of problem is it?
Single Choice · Safety incident, Quality defect, Equipment failure, Late or wrong shipment, Customer complaint, Something else
When did it happen?
Date
Where did it happen?
Short Text
Describe what happened
Long Text
What was the impact?
Multiple Choice · Injury, Scrap or rework, Downtime, Late orders, Customer impact, Cost
Ask why five times
Long Text
Which kinds of causes played a part?
Multiple Choice · People, Methods, Machines, Materials, Measurements, Environment
What's the root cause?
Long Text
What corrective actions will fix it?
Long Text
When should all actions be finished?
Date
How will you check the fix worked?
Long Text · Optional
Upload photos or documents
File · Optional
How to use this template
Copy it
Select Use template and a copy opens in your workspace as an unpublished draft.
Make it yours
Edit any question or answer, choose a theme, and add your logo.
Share it
Publish, then send the link, show a QR code, or embed the form on your site. Responses arrive in Submissions.
Frequently asked questions
What should a root cause analysis form include?
The problem, when and where it happened, its impact, a 5 whys chain, the kinds of causes involved, the root cause, corrective actions with owners and dates, and how you'll check the fix.
When should a team do a root cause analysis?
After any safety incident, repeat quality defect, customer complaint or equipment failure that you don't want to see again.
Can several people work on one analysis?
Each response is filled in by one person. Most teams meet, agree on the answers together, and have one person submit the form.