R-15 — Independent review report
Purpose: Record a reviewer’s source, method and fairness checks.

Package and version:

Conflict check:

Scope reviewed:

Source verification sample:

Contrary material assessment:

Privacy check:

Required corrections:

Decision and reasons:

Reviewer signature date:

COMPLETION CHECKS
[ ] Reviewer must be independent of the original conclusion
[ ] Return unsupported claims
[ ] Record recusals

Prepared by:
Date:
Version:
Reviewer / approval:

Blank template. Keep completed records in the approved channel. This template does not grant authority.