UCOP PROGRAM MANAGEMENT OFFICE
Change Management Service Request Form
Process:
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Please complete and return this form to Zoanne Nelson at zoanne.nelson@ucop.edu
We will respond within 48 hours of your request regarding status or next steps
If you have any questions, please contact zoanne.nelson@ucop.edu
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Date of Request:
Requestor Name:
Division, Department, Unit:
Project Intake Questions:
1.
What is the problem or opportunity ?
2.
What are the key risks, issues, and dependencies 1 ?
1 A risk is an uncertain event or condition that may have a positive or negative effect on a project’s outcome. An issue is a matter in dispute or that need further resolution. A dependency is a relationship in which a task relies on other tasks to be performed
(completely or partially) before it can be performed.
Last updated 4/20/2015 Page 1

UCOP PROGRAM MANAGEMENT OFFICE
Change Management Service Request Form
3.
Who are the key players 2 (sponsor(s), stakeholders, etc.)?
4.
What is the service being requested ? Please see comments below for brief description of services.
Services the PMO provides:
• Organizational Development & Change Management
• Project Management
• Meeting and workshop facilitation
•
*For Consulting services, there may need to be a re-evaluation period if additional work is needed beyond the original finite schedule (e.g., problem statement turns into need for project management expertise)
2 A sponsor champions the project and promotes the benefits that the project will bring. The sponsor approves the project scope, authorizes changes in scope, and makes go/no-go decisions. The sponsor sets high-level direction and monitors check-points. A stakeholder is a person with an interest or concern in the project.
Last updated 4/20/2015 Page 2

UCOP PROGRAM MANAGEMENT OFFICE
Change Management Service Request Form
5.
What is the timeframe for the service provided? Please include:
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Estimated Duration: start and end dates
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Expected Effort: for defined duration, how many hours/week
6.
What are your expectations of the deliverables and services?
7.
What are the funding parameters?
Last updated 4/20/2015 Page 3