Change Control Form Automation

I have a one page form used to track IT and Web related changes in my environment. I am tired of the paper system and hence; I seeking bids to automate the form and make it available online on my intranet. I have attached the form and workflow to assist you in coming up with a CMS website to accommodate the task. The system must guarantee records protection and retention, system access controls, authority checks, electronic signature, and audit trail.

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