Appendix C Example of a phase 2 request for change form
| Data element | Description | Comments |
| Tracking number | Unique ID number assigned by change manager/CAB | |
| Description | High-level description of the proposed change in business terms | |
| Business case | Summary business case stating the intended value to be realized | |
| Business outcomes | Description of the business outcomes anticipated from the proposed change | Outcomes should be specific and measurable |
| Elements to be changed | Identification (at a high level) of which IT services and infrastructure components are involved with the proposed change | |
| Reason for change | The business case supporting the change proposal, in business terms, including the desired outcomes the business intends to achieve | |
| Change category | High-level category of change – maintenance, major etc. | |
| Risk management | Initial assessment of risks and high-level plan to manage | |
| Change window | The change window the change is targeting for release | |
| Acceptance criteria | Description of the specific test results that will define success | Should be specific and measurable. Criteria should be tied to desired outcomes (above) |
| Roll-back plan | High-level plan to correct or roll back the change proposal | |
| Implementation schedule | High-level timeline of implementation date(s) | |
| High-level architecture | Block diagram showing the service components, both new and existing, that are involved with the proposed change |
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