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Employee Exit Interview Form: Reason For Leaving

This exit interview form consists of three sections: (1) questions about the employee's reasons for leaving and experience working at the company; (2) ratings of various aspects of the job like responsibilities, growth opportunities, work environment, and compensation; (3) an open comment section. The company conducts exit interviews to gather feedback to improve the work environment and assess quality of work-life. Responses will be kept confidential with a summary report provided to senior management periodically.

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1K views

Employee Exit Interview Form: Reason For Leaving

This exit interview form consists of three sections: (1) questions about the employee's reasons for leaving and experience working at the company; (2) ratings of various aspects of the job like responsibilities, growth opportunities, work environment, and compensation; (3) an open comment section. The company conducts exit interviews to gather feedback to improve the work environment and assess quality of work-life. Responses will be kept confidential with a summary report provided to senior management periodically.

Uploaded by

Secret Secret
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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EMPLOYEE EXIT INTERVIEW FORM

We are very sorry to see you go. Before you do, we would appreciate hearing from you.
We kindly ask for your feedback regarding your work experience with us.

We are committed to providing a positive work environment for our employees and this
exit interview process provides a valuable source of information to assist us in
assessing the overall quality of work-life. We would appreciate a few moments of your
time to complete the following questionnaire.

Your responses will be treated with complete confidence and a summarized report of all
exit interviews conducted will be provided to the senior management team periodically.
Providing your name is optional and the link that was sent to you is not a unique link
and is not tied to your name.

Thank you for your participation!

Name: Date Hired:

Title/Position: Date Separated:

Department: Employment Status:

Reason for Leaving

Resignation Termination

[ ] Job Offer from other company [ ] End of Contract


[ ] Family / Personal [ ] Violation of Company Policy
[ ] Relocation [ ] Lay Off
[ ] Problem with Colleagues / Supervisor [ ] Reorganization
[ ] Return to School [ ] Health Issue
[ ] Position Eliminated [ ] Client Pull-out
[ ] Redundancy [ ] Other

Signature: __________________________
Employee Name: __________________________
Date: ______________
EMPLOYEE EXIT INTERVIEW FORM

A. QuestionnaireS
1. What are your primary reasons for leaving?

2. Did anything trigger your decision to leave?

3. What’s the most satisfying about your job?

4. What’s the least satisfying about your job?

5. What would you change about your job?

6. Did your duties turn out to be as you expected?

7. Any challenges that you encounter along the way?

Signature: __________________________
Employee Name: __________________________
Date: ______________
EMPLOYEE EXIT INTERVIEW FORM

8. Did you receive enough training to do your job effectively? Please give brief details

9. Did you receive adequate support to do your job effectively? Please give brief details

10. Did this company help you to fulfill your career goals?

11. What would you suggest to improve our workplace better?

12. Generally, how was the working environment in the company?

13. Were you happy with your pay, benefits and other incentives given to you?
Please give brief details

14. What was the quality of the supervision you received? Please give brief details

15. What could your immediate manager do to help improve his/her management style?

16. Based on your experience with us, what do you think it takes to succeed at this company?

Signature: __________________________
Employee Name: __________________________
Date: ______________
EMPLOYEE EXIT INTERVIEW FORM

17. Did any company policies or procedures (or any obstacles) make your job more difficult?

18. How do you generally feel about this company?

19. What does your new employer offer that this company doesn’t?

20. What do you think the company needs to improve?

21. Would you consider working again for this company in the future?

22. Is there anything that the company could have done to prevent you from resigning?

23. What does your new employer offer that this company doesn’t?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

Signature: __________________________
Employee Name: __________________________
Date: ______________
EMPLOYEE EXIT INTERVIEW FORM

B. How would you rate the following:

➢ Job responsibilities

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Opportunities for growth

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Work environment

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Colleagues

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Supervisor

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Compensation

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Benefits

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Policies and Procedures

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Management

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

➢ Over-all

 Outstanding  Very Good  Satisfactory  Fair  Unsatisfactory

Signature: __________________________
Employee Name: __________________________
Date: ______________
EMPLOYEE EXIT INTERVIEW FORM

C. Employee Comments:

Interviewed by: Date

Remarks:

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Signature: __________________________
Employee Name: __________________________
Date: ______________

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