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U.S. Department of Health and Human Services

Inspections, Compliance, Enforcement, and Criminal Investigations

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Appendix G Audit Report (Form FDA 3611)

ORA FIELD MANAGEMENT DIRECTIVE No. 76
Appendix G

Subject:
State Contracts-Evaluation of Inspectional Performance
Area:
State Program Management
Date:
8/22/6 Revised

Appendix G

Audit Report (FDA 3611)

This form must be completed at the end of the contract performance period for audits of tissue residue, medical device, and other contract inspection programs. Refer to Section III, Part E of this FMD for specific reporting instructions.

The form is in Portable Document Format (PDF) and may be filled and then printed for easier use. To view or print the document, you must use Adobe Acrobat Reader, which is free and available directly from Adobe’s website with full installation instructions.

This report form is located at:

http://www.fda.gov/opacom/morechoices/fdaforms/FDA-3611.pdf

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