Energy Project Change Management Checklist Template

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Initiation & Scope Definition

1 von 10

Assess the initial need for a change and define its scope.

Change Request Description

Change Urgency

Estimated Impact Score (1-10)

Date of Change Request

Initiating Department

Reason for Change

Impact Assessment

2 von 10

Evaluate the potential impact of the change on project timelines, budget, resources, and stakeholders.

Estimated Cost Increase

Estimated Schedule Delay (Days)

Impact on Project Scope

Description of Potential Risks

Impact on Quality

Affected Project Areas

Risk Identification & Mitigation

3 von 10

Identify potential risks associated with the change and outline mitigation strategies.

Describe Potential Risks Associated with the Change

Estimated Probability of Risk Occurrence (0-10)

Estimated Impact of Risk (1-10)

Detailed Mitigation Strategy

Risk Owner

Mitigation Completion Date

Risk Category

Related Project Documents

Approval & Authorization

4 von 10

Document approval levels and signatures required for change implementation.

Change Approval Level Required

Requester Name

Request Date

Requester Signature

Approver Name (Level 1)

Approval Date (Level 1)

Approver Signature (Level 1)

Approver Name (Level 2 - if applicable)

Approval Date (Level 2 - if applicable)

Implementation Planning

5 von 10

Develop a detailed plan for implementing the change, including tasks, responsibilities, and timelines.

Planned Start Date

Planned Completion Date

Estimated Duration

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23:45

Estimated Effort (Hours)

Tasks Involved (Select All)

Implementation Approach

Detailed Implementation Steps

Resource Allocation

6 von 10

Confirm availability of required resources (personnel, equipment, materials).

Estimated Labor Hours

Required Equipment Units

Specialized Personnel Needed?

Required Skills/Expertise

Resource Availability Start Date

Communication & Stakeholder Management

7 von 10

Outline communication plan to keep stakeholders informed about the change.

Communication Plan Summary

Primary Communication Method

Stakeholders to Inform

Next Communication Date

Communication Owner

Supporting Communication Documents

Implementation & Execution

8 von 10

Monitor progress against the implementation plan and address any deviations.

Planned Start Date

Planned Start Time

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Estimated Completion % (Initial)

Brief Execution Notes (Initial)

Current Status

Supporting Documentation (e.g., Photos)

Verification & Testing

9 von 10

Verify the change has been implemented correctly and meets requirements.

Verification Method

Number of Test Cases Passed

Total Number of Test Cases Executed

Test Results Summary

Verification Date

Verification Time

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Verification Signature

Documentation & Closure

10 von 10

Update project documentation to reflect the change and formally close the change management process.

Summary of Changes Implemented

Date of Change Implementation

Time of Change Implementation

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Project Manager Signature

Change Request Status

Total Hours Spent on Change

Supporting Documentation (e.g., revised drawings)

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