DFM Analysis Report

Part / revision: __________Material / lot: __________Prepared by / date: __________Customer requirements: __________

Review item	Evidence / result	Status
Design concern	To be recorded	Pending review
Recommended change	To be recorded	Pending review
Owner and closure	To be recorded	Pending review

Record actual measurements and supporting evidence before review and authorization. No approval, laboratory result or conformity claim is implied by this blank template.