Gage R&R Template Sample

Validation Protocol Measurement System Analysis Measurement System Analysis: Name Project Here Ref: XXXX

Rev: 1

Page No 1 of 3

Protocol Approval Name

Responsible

Signature

Date

Signature

Date

Protocol Execution Approval Name

Page 1 of 3

Responsible

XXX – MSA - XXX Purpose and Scope: The purpose of this protocol is to validate the repeatability of XXXXXX (describe the purpose and the scope here) Strategies and Rationale (The rationale and strategy of the Measurement System Analysis should be described here) Acceptance Criteria: Acceptance criteria will be based on 100% of samples from operators 1 – 3 passing the test.

(Describe any further Acceptance Criteria here) Equipment and Materials Describe any Equipment /Material used in the course of the validation

Related Documents: List all related documents here Version

Date

Author

Change

1.0

XXX

XXX

New document

Section 1 – XXXXXXX

Protocol Number: XXX-MSA-XXXX Page 2 of 3

Version 1.0

XXX – MSA - XXX Step 1.1

Method Select three personnel to test the application of xxxxxxx

Record Entry Operator 1 (Initial/date):

Read the attached test method before executing this protocol.

Record details opposite.

Operator 2 (Initial/date):

Operator 3 (Initial/date):

Protocol Number: XXX-MSA-XXXX Page 3 of 3

Version 1.0