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Validation Retest / Re-execution Authorization Form

A plug-and-play authorization form controlling when a failed validation test may be re-executed: verified root cause, completed and independently verified corrective action, defined re-test and regression scope, the testing-into-compliance attestation gate, and tiered approvals by GxP impact.

Document type: Form

Read and copy the template below into your own quality system. It is a generic starting point for your own internal use, provided as is, with no warranty; see the Terms and License. Adopting it does not by itself create compliance.

This is a ready-to-use form. Replace every <<FILL: ...>> placeholder with your own specifics, set your document numbers and dates, and route it through your normal document control, review, and approval. A worked filled specimen follows the template so you can see how a completed version reads. Verify each cited regulation against the current published source before you rely on it, and treat this as an educational reference to adapt rather than as legal or regulatory advice.

One form covers one authorization to re-execute. It is completed and approved before the re-execution runs, never after. The governing process sits in SOP: Validation Test Incident Management.

Why this form exists

Re-running a failed test is the single most scrutinized action in validation execution. A legitimate re-test and testing into compliance look identical in the final result: both end in a PASS. What separates them is what was known and approved beforehand. This form is the record of what was known beforehand.

If a reviewer asks “why were you allowed to run this again?”, this form is the answer.

Form control header

FieldEntry
Form titleValidation Retest / Re-execution Authorization
Authorization number<<FILL: RTA-ID, e.g. RTA-OQ-LIMS-009>>
Form template number and version<<FILL: FRM-ID and version>>
Date raised<<FILL: date>>
Raised by (name, role)<<FILL>>
Validation project<<FILL: project name and number>>
StatusDraft / Approved / Executed / Void

Field table

Complete every required field. Where a field is not applicable, write N/A with a reason. Do not leave a required field blank.

#FieldFormatRequiredWho completesWhen
1Authorization numberText, per local numbering schemeYesValidation leadOn raising
2Test incident numberText, links to the test incident logYesValidation leadOn raising
3QMS deviation numberText, or N/A with reasonConditional (required for classes C3 to C6)Validation leadOn raising
4Incident classificationControlled list, C1 to C6YesQA (confirmed)Before approval
5Protocol number, title, versionTextYesValidation leadOn raising
6Validation phaseControlled list: DQ / IQ / OQ / PQ / UAT / method validation / process validation / cleaning validationYesValidation leadOn raising
7Original failed test case and stepTextYesValidation leadOn raising
8Original failure date and timeDate and 24-hour timeYesValidation leadOn raising
9Original failed record referenceText, page or record identifierYesValidation leadOn raising
10Verified root cause statementFree text, specific and evidencedYesValidation lead or SMEBefore approval
11Root cause evidence referenceText, attachment identifiersYesValidation lead or SMEBefore approval
12Corrective action takenFree textYesValidation lead or SMEBefore approval
13Change control referenceText, or N/A with reasonConditional (required where a controlled item changed)Validation leadBefore approval
14Corrective action completion dateDateYesImplementerOn completion
15Corrective action verified by (independent)Name, role, date, signatureYesA person other than the implementerOn verification
16Scope and impact assessment referenceText, or N/A with reasonConditional (required for classes C3 to C6)Validation leadBefore approval
17Re-test scope: primaryTest case and step listYesValidation leadBefore approval
18Re-test scope: regressionTest case list, or “none” with justificationYesValidation leadBefore approval
19Scope justificationFree textYesValidation leadBefore approval
20Environment or instanceTextYesValidation leadBefore approval
21Build, version, or firmwareText, exact version stringYesValidation leadBefore approval
22Configuration set or recipe referenceTextYesValidation leadBefore approval
23Test data set referenceTextYesValidation leadBefore approval
24Acceptance criterion for the re-testText, quoted from the approved protocolYesValidation leadBefore approval
25Testing-into-compliance attestationSigned statementYesValidation leadBefore approval
26ApprovalsNames, signatures, datesYesPer the tier tableBefore execution
27Re-execution record referenceTextYesExecutorAfter execution
28Re-execution resultControlled list: Pass / FailYesExecutorAfter execution
29New incident number if the re-test failedText, or N/AConditionalValidation leadAfter execution
30Closure confirmationName, signature, dateYesQA for classes C4 to C6, validation lead for C1 to C3On closure

1. Incident reference and context

FieldEntry
Test incident number<<FILL: TI number>>
QMS deviation number<<FILL: deviation number, or N/A with reason>>
Incident classification (QA confirmed)C1 test script error / C2 execution error / C3 environment, build or test data / C4 defect, low GxP impact / C5 defect, high GxP impact / C6 data integrity event
Protocol number, title, version<<FILL>>
Validation phase<<FILL>>
System, equipment, method, or process<<FILL>>
Original failed test case and step<<FILL>>
Original failure date and time<<FILL>>
Original failed record reference<<FILL: execution page or record ID, which remains in the package marked FAIL>>
Number of prior re-execution attempts on this step<<FILL: 0, 1, 2 ...>>

If prior attempts exist, state each attempt reference and result. Where the attempt count reaches the limit set in your procedure, this form is not the right route; escalate instead.

2. Verified root cause

A re-test is authorized on the strength of a known cause. An unknown cause means the re-test would only be an experiment to see whether the failure recurs, which is not an authorized activity under this form.

FieldEntry
Root cause statement<<FILL: the specific, verified cause. Name the parameter, the code path, the step, the setting, or the condition>>
Investigation method used<<FILL: e.g. five-whys, fishbone, configuration comparison, log review, code review>>
Evidence confirming the cause<<FILL: attachment identifiers and what each shows>>
Was the cause reproduced or otherwise confirmed?Yes, how: <<FILL>> / No, why the cause is nonetheless verified: <<FILL>>
Root cause accepted by<<FILL: name, role, date, per the authority matrix in your procedure>>

A statement that restates the symptom is not acceptable here. “The report printed a blank batch number” is the symptom. “The report template referenced field BATCH_ID_EXT, which is only populated for externally manufactured lots, instead of BATCH_ID” is a cause.

3. Corrective action, completed and independently verified

FieldEntry
Corrective action description<<FILL: exactly what was changed, by whom>>
Type of changeSoftware fix / Configuration change / Equipment repair or adjustment / Method or recipe correction / Protocol correction or addendum / Test data correction / Environment restoration / Training or procedure change / Other <<FILL>>
Change control reference<<FILL: CR number, or N/A with reason>>
Protocol addendum reference (if the protocol changed)<<FILL: addendum number, or N/A>>
CAPA reference (if recurrence prevention needed)<<FILL: CAPA number, or N/A with reason>>
Implemented by (name, role, date)<<FILL>>
Completion verified by (name, role, date, signature)<<FILL: must not be the implementer>>
How completion was verified<<FILL: e.g. configuration export compared against specification; code diff reviewed; calibration certificate reviewed>>

Gate 3A. If the corrective action is not complete at the time of signing, this form is not approvable. Re-executing “while the fix is being finalized” produces a result that belongs to neither the broken nor the fixed state.

Gate 3B. Verification of completion is performed by someone other than the person who implemented the change. Self-verification of one’s own correction is one of the easiest findings for a reviewer to spot from the signature block alone.

4. Re-test scope and its justification

Scope is where a re-test authorization earns its keep. The failing step is the obvious part. Everything the correction could have disturbed is the part teams under schedule pressure cut.

4.1 Primary scope

FieldEntry
Test cases and steps to re-execute<<FILL: list every test case and step>>
Acceptance criterion, quoted from the approved protocol<<FILL: quote it exactly. Do not paraphrase and do not restate it in a way that is easier to meet>>
Was the acceptance criterion changed as part of this incident?No / Yes, protocol addendum <<FILL>>, approved by <<FILL>> on <<FILL: date>>

If the acceptance criterion changed, the change is approved separately at the level that approved the original protocol, with the original text, the corrected text, and the justification recorded. A criterion may not be relaxed in this form.

4.2 Regression scope

Work the prompts below and record an answer for each. The default answer to “should we run regression?” is yes. A “no” needs a reason a reviewer would accept.

Regression promptAnswerTest cases added to scope
Does the correction touch shared logic, a shared calculation, or a shared library used elsewhere?Yes / No<<FILL>>
Does it touch a shared configuration object, template, recipe, or master data record?Yes / No<<FILL>>
Does it touch an interface to or from another system?Yes / No<<FILL>>
Does it touch a security role, permission set, or workflow routing?Yes / No<<FILL>>
Does it touch an audit trail, electronic signature, or record-retention behaviour?Yes / No<<FILL>>
Were any test cases already recorded as PASS while the defective condition was present?Yes / No<<FILL: these are re-executed, see the scope and impact assessment>>
Did the environment or build change between the original execution and this re-test?Yes / No<<FILL>>
Does the vendor’s release note for the fix list any other changed component?Yes / No / N/A<<FILL>>
FieldEntry
Regression test cases in scope<<FILL: full list, or "none">>
Regression scope justification<<FILL: why this set is sufficient, and specifically why anything excluded can be excluded>>
Regression waived?No / Yes, justification <<FILL>>, QA approver <<FILL>>

4.3 Scope justification statement

<<FILL: two to five sentences explaining the scope. State what the correction touched, what could plausibly have been affected, what is therefore in scope, and what is excluded and why. A reviewer should be able to disagree with the reasoning, which means the reasoning has to be visible.>>

5. Environment and build the re-test will run on

A re-test that runs on a different environment or build than the one intended proves nothing about the intended one. Confirm and record the exact configuration.

FieldEntry
Environment or instance name<<FILL>>
Build, version, or firmware (exact string)<<FILL>>
Environment matches the qualified target environment?Yes / No, difference and justification <<FILL>>
Configuration set, recipe, or method reference<<FILL>>
Test data set reference and its controlled state<<FILL>>
Interfaces active or stubbed<<FILL: list, and state which are live>>
Environment confirmed by (name, role, date)<<FILL>>
Evidence of environment confirmation<<FILL: e.g. version screen capture, deployment record, configuration export>>

6. Testing-into-compliance attestation

This is the gate. Read each statement, answer honestly, and sign. A “No” on any statement means the re-execution is not authorized and the form is returned.

#StatementResponse
1The root cause of the original failure is understood and documented, not assumed.Yes / No
2The corrective action is complete and its completion has been independently verified.Yes / No
3This re-test is being run because a specific condition changed, not to see whether the failure recurs.Yes / No
4The acceptance criterion for the re-test is the original approved criterion, or a criterion changed through an approved, justified protocol change that was not made easier to satisfy.Yes / No
5The original failed record remains in the validation package, marked FAIL, and has not been erased, blanked, overwritten, or amended to PASS.Yes / No
6The re-execution will be recorded as a new, separately dated and signed record referencing the incident number.Yes / No
7Every prior re-execution attempt on this step is disclosed in section 1.Yes / No
8The regression scope in section 4.2 was determined by what the correction could affect, not by what time allows.Yes / No

Attestation. I confirm that the responses above are accurate, that this re-execution is not being requested in order to obtain a passing result without an understood and corrected cause, and that I am aware that repeated re-execution without a corrected cause constitutes testing into compliance.

FieldEntry
Attested by (name, role)<<FILL: validation lead or equivalent>>
Signature and date<<FILL>>

7. Approvals

Approval level rises with GxP impact. No person signs more than one row on the same form, and the executor of the original test does not approve its re-execution.

Incident classificationValidation leadSystem / process ownerQuality AssuranceHigher authority (Quality Head or delegate)
C1 test script or expected-result errorApprovesInformedNotifiedNot required
C2 execution errorApprovesInformedNotifiedNot required
C3 environment, build, or test data issueRecommendsInformedApprovesNot required
C4 defect, low GxP impactRecommendsReviewsApprovesNot required
C5 defect, high GxP impactRecommendsReviewsApprovesApproves
C6 data integrity eventRecommendsReviewsApprovesApproves
RoleNameSignatureDate
Prepared by (validation lead)<<FILL>>
Technical review (SME)<<FILL>>
System / process owner<<FILL>>
Quality Assurance<<FILL>>
Higher authority (required for C5, C6)<<FILL>>

Rule. The latest approval date on this form is on or before the re-execution date recorded in section 8. A form approved after the re-execution ran is not an authorization; it is a retrospective justification, and the audit trail will show the order.

8. Re-execution outcome

Completed after the re-execution runs.

FieldEntry
Re-execution record reference<<FILL: new execution record, addendum, or page identifier>>
Executed by (name, role)<<FILL: may not be the sole approver of this form>>
Execution date and time<<FILL>>
Result against the stated acceptance criterionPass / Fail
Evidence attached<<FILL: attachment identifiers>>
Regression tests executed and results<<FILL: list with pass or fail>>
If failed, new incident number raised<<FILL: TI number, or N/A>>
Original incident status after this re-executionClosed-resolved / Still open / Superseded by <<FILL>>
Closure confirmed by (name, role, date)<<FILL: QA for C4 to C6>>

A failed re-execution raises a new incident referencing the original. It does not reopen the same authorization for a further attempt, because reusing the authorization hides how many attempts were made.

9. References

21 CFR 211.192, which requires that unexplained discrepancies be thoroughly investigated with the conclusion and follow-up recorded. The same logic applies to a failed validation test result. 21 CFR Part 11, for the integrity and attributability of electronically captured re-execution evidence. EU GMP Annex 15, Qualification and Validation (2015), which requires deviations from validation protocols to be documented with appropriate justification under quality risk management. EU GMP Annex 11, Computerised Systems (2011, currently in force), for reporting and assessment of deviations arising during validation. The revision published in draft on 7 July 2025, consultation closed 7 October 2025, is not final. ICH Q9(R1), Quality Risk Management, for the risk basis of the approval tiers. FDA guidance “Computer Software Assurance for Production and Quality Management System Software”, issued 3 February 2026, for the risk-based assurance context. FDA 2018 data integrity guidance, MHRA GxP Data Integrity Guidance and Definitions, and PIC/S PI 041, for the ALCOA+ expectations applied to the re-execution record. ISPE GAMP 5 Second Edition (2022), for the lifecycle context. Reference only.

Confirm the current version and clause numbers of each reference before issue.


Filled specimen

The following shows the form completed for a re-execution during the OQ of a laboratory information management system in a biologics QC laboratory. The company, system, names, and numbers are illustrative.

Sections 1 to 3

FieldEntry
Authorization numberRTA-OQ-LIMS-009
Test incident numberTI-OQ-LIMS-014
QMS deviation numberVAL-DEV-2026-031
Incident classification (QA confirmed)C5, defect, high GxP impact
ProtocolOQ-LIMS-008, Operational Qualification of the LIMS, v1.1
Validation phaseOQ
SystemLIMS, instance LIMS-QUAL
Original failed test case and stepTC-017 step 3, specification evaluation of a potency result against the release limit
Original failure date and time06 July 2026, 09:41
Original failed record referenceOQ-LIMS-008 execution page 24, marked FAIL, annotated “see TI-OQ-LIMS-014”
Prior re-execution attempts on this step0
Root cause statementThe specification evaluation applied the release limit as an exclusive comparison (result must be strictly greater than 80.0 percent) rather than the inclusive comparison specified in URS-LIMS-044 (result greater than or equal to 80.0 percent). A boundary result of exactly 80.0 percent was evaluated as out of specification. The comparison operator was set to ”>” in the specification rule builder; the configuration specification did not state which operator to use.
Investigation methodConfiguration export compared against URS-LIMS-044 and the analytical method; five-whys on the build step
Evidence confirming the causeATT-1 specification rule export showing ”>”; ATT-2 URS-LIMS-044 extract; ATT-3 boundary test screenshots at 79.9, 80.0, 80.1 percent
Cause reproduced?Yes, reproduced on three boundary values on 06 July 2026
Root cause accepted byJ. Mbeki, Validation Lead, 08 July 2026; confirmed by S. Larsen, QA, 08 July 2026
Corrective action descriptionComparison operator changed from ”>” to ”>=” on the potency release specification rule, and on the four other release specification rules built in the same session
Type of changeConfiguration change
Change control referenceCR-LIMS-2026-063
CAPA referenceCAPA-2026-039, add an explicit operator column to the specification configuration workbook and a second-person verification step in the build checklist
Implemented byT. Nguyen, LIMS Administrator, 09 July 2026
Completion verified byR. Adeyemi, LIMS Analyst, 09 July 2026, signed
How completion was verifiedConfiguration export re-pulled and compared line by line against URS-LIMS-044 and the four other affected specification rules

Section 4, scope

FieldEntry
Scope and impact assessment referenceSIA-014
Primary re-test scopeTC-017 steps 3, 4, and 5, executed at boundary values 79.9, 80.0, and 80.1 percent
Acceptance criterion, quoted”A potency result equal to or greater than 80.0 percent shall be evaluated as within specification; a result below 80.0 percent shall be evaluated as out of specification and flagged for investigation.” (OQ-LIMS-008 v1.1, TC-017)
Acceptance criterion changed?No
Shared logic touched?Yes, the specification rule engine is shared across all release specifications
Shared configuration object touched?Yes, four other release specification rules built in the same session
Interface touched?No
Security role or workflow touched?No
Audit trail or signature behaviour touched?No
Test cases already PASS while the defect was present?Yes, TC-018 and TC-019 evaluated non-boundary results only and never challenged the boundary
Environment or build changed since original execution?No, build 9.1.4 throughout
Regression test cases in scopeTC-018 and TC-019 re-executed with boundary values added; new boundary checks added for the four other affected specification rules (TC-020a to TC-020d)
Regression scope justificationThe correction changed a comparison operator on five specification rules sharing one rule engine. Any test whose result depended on a specification evaluation could have passed only because it never exercised the boundary, so all specification-evaluation test cases are re-executed with boundary values added. Test cases TC-021 onward cover sample login and worklist routing, which do not call the specification rule engine, and are therefore excluded.
Regression waived?No

Sections 5 to 8

FieldEntry
EnvironmentLIMS-QUAL
Build9.1.4
Environment matches qualified target?Yes
Configuration setSpecification rule set SPEC-REL-2026-02 as amended by CR-LIMS-2026-063
Test data setTD-LIMS-07, controlled, checked out 10 July 2026
Interfaces active or stubbedInstrument interface stubbed; ERP interface not exercised by these test cases
Environment confirmed byJ. Mbeki, 10 July 2026, version screen capture ATT-4
Attestation statements 1 to 8All Yes
Attested byJ. Mbeki, Validation Lead, signed 10 July 2026
ApprovalsPrepared J. Mbeki 10 July; SME review T. Nguyen 10 July; System owner P. Costa 10 July; QA S. Larsen 10 July; Quality Head D. Rahman 10 July (required, C5)
Re-execution record referenceOQ-LIMS-008 addendum 1, pages A1 to A9
Executed byR. Adeyemi, LIMS Analyst
Execution date and time13 July 2026, 08:15 to 11:40
ResultPass. 80.0 percent evaluated as within specification; 79.9 percent evaluated as out of specification and flagged; 80.1 percent within specification
Regression resultsTC-018 Pass, TC-019 Pass, TC-020a to TC-020d all Pass at boundary
New incident raisedN/A
Original incident statusClosed-resolved
Closure confirmed byS. Larsen, QA, 15 July 2026

Read the specimen in order and the logic is visible: the cause names a specific operator and the specification gap that allowed it, the correction was verified by someone other than the person who made it, the regression scope was set by what the shared rule engine could reach rather than by what the schedule allowed, the boundary values were the exact values that exposed the defect, and every approval date precedes the execution date. That last point is what an audit trail check will confirm or contradict.

Common inspection findings this form prevents

  • Re-execution records that exist with no documented authorization, so there is no evidence anyone decided the re-test was legitimate.
  • Authorization forms signed after the re-execution ran, contradicted by the system audit trail.
  • Re-tests approved with the root cause recorded as “unknown” or “not determined”, meaning the re-test was an attempt to see whether the failure would recur.
  • Corrective actions verified by the same person who implemented them.
  • Re-execution performed on a different build or environment than the one the failure occurred on, with the difference unrecorded.
  • Acceptance criteria quietly relaxed between the original execution and the re-test, so the re-test passes against an easier target.
  • Regression skipped after a fix to shared logic, with no justification and no QA sign-off on the omission.
  • Test cases that passed while a defective condition was present, left as PASS and never revisited.
  • Multiple re-execution attempts on the same step recorded as a single authorization, so the number of attempts is not visible.
  • Higher-impact re-tests approved at the same level as trivial ones, with no escalation for GxP-critical functions.
  • The person who executed the failing test also approving its re-execution.

How to adapt this form

  1. Set your form number, numbering scheme, and the incident classification labels in section 1 to match your own procedure. If you use Critical, Major, and Minor rather than C1 to C6, rewrite the approval tier table in section 7 against your own severity terms and keep the escalation at the top severity.
  2. Decide which classes require a QMS deviation number in field 3 and make that conditional rule explicit, so a form cannot be approved with the field left blank.
  3. Add any regression prompts specific to your technology to section 4.2. Systems with recipe inheritance, master data hierarchies, multi-tenant configuration, or shared report templates each deserve their own prompt.
  4. If you run paper execution, add a field for the controlled copy number of the re-execution pages so the new record is traceable to a controlled issue.
  5. Set your attempt limit in your governing procedure and add a field to section 1 that forces disclosure of the count. The count is the signal, and hiding it is how testing into compliance survives review.
  6. Keep the attestation in section 6 as a signed statement rather than a tick box. A signature against a named statement is materially different from an unattributed mark.
  7. If your electronic QMS holds this form, configure the workflow so the approval step cannot be completed after the execution record is created, and so the executor cannot be selected as an approver.
  8. Confirm every regulation in section 9 against the current published version before issue, in particular the status of the EU GMP Annex 11 revision, which was still in draft at the time of writing.
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