PQ Template For Students

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Performance Qualification Protocol No: PQ PPP-XXX

Title: Name of system (Tag No) Page 1 of 4

PERFORMANCE QUALIFICATION PROTOCOL

ITEM: NAME OF SYSTEM (TAG No)

Responsibilities Name / Title Signature Date


Protocol Prepared by

Protocol Reviewed by

Protocol Approved for Execution by:

Name Title Signature Date


QA Department
Performance Qualification Protocol No: PQ PPP-XXX

Title: Name of system (Tag No) Page 2 of 4

Table of Contents

1.0 Introduction
2.0 Purpose and Scope
3.0 Responsibilities
4.0 Data Collection and Personnel Identification
5.0 Precautions and Safety
6.0 Materials
7.0 Performance Testing Procedure
8.0 Acceptance Criteria
9.0 Deviation Reports
10.0 References and Related Documents
Performance Qualification Protocol No: PQ PPP-XXX

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1.0 Introduction

This section provides background information of the purpose and scope of the performance
qualification study.

2.0 Purpose and Scope

2.1 Purpose

In this section outlines what the validation study is going to prove.

2.2 Scope

In this section gives the scope of the study.

3.0 Responsibilities

Appoint a study director who will be responsible for the organization of this study and report

4.0 Data Collection and Personnel Identification

All personnel authorised to perform this study must be stated on the PQ report. All test data and
results collected must be attached to the PQ report as attachments.

5.0 Precautions and Safety

5.1 In this section, state the precautions to be taken for the safety of operators, equipment and
product. Use sub-sections as necessary.

6.0 Materials

6.1 In this section states all materials needed for the validation study.

7.0 Performance Testing Procedure

7.1 Provide detailed procedures on how to perform the validation study.

8.0 Acceptance Criteria

8.1 Provide acceptance criteria for the parameters or characteristics of the equipment/method in
this validation study.
Performance Qualification Protocol No: PQ PPP-XXX

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9.0 Deviation Reports

State all deviations that occurred during the execution of this protocol.

10.0 References and Related Documents

List all related documents (e.g., SOPs, WIs, book, articles, batch records etc.) as detailed as
possible related to this validation study.

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