Policy and procedure template

Policy and Procedure

Policy no.: Policy Number

Version: Version Number

Effective date: Effective Date

Title: Policy Title

Owning department: Owning Department

Purpose: Purpose

Scope: Scope

Policy: Policy Statement

Procedure: Procedure Steps

Responsibilities: Responsibilities

References: References

Next review date: Next Review Date

Prepared by: Prepared By – Signature: Signature

Approved by: Approver Name – Signature: Approver Signature