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Exit Interview Form

The document is an exit interview form containing questions about an employee's reasons for leaving, their experience working at the company including their opinion of their superior and various job aspects, and suggestions for improvement. The form asks for feedback on topics such as benefits, workload, training, and recommendations.

Uploaded by

Jontan R. Nober Tampubolon, S.H.
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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44 views

Exit Interview Form

The document is an exit interview form containing questions about an employee's reasons for leaving, their experience working at the company including their opinion of their superior and various job aspects, and suggestions for improvement. The form asks for feedback on topics such as benefits, workload, training, and recommendations.

Uploaded by

Jontan R. Nober Tampubolon, S.H.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 3

EXIT INTERVIEW

Employee Name : Superior :


Department : Job Title :
Hire Date : Termination Date :

1. Why are you leaving this company?

2. What circumstances would have prevented your departure?

3. What did you like most about your job?

4. What did you like least about your job?

5. What did you think of your superior on the following points:

Almost Always Usually Sometimes Never

Was consistently fair ( ) ( ) ( ) ( )


Provided recognition ( ) ( ) ( ) ( )
Resolved complaints ( ) ( ) ( ) ( )
Was sensitive to employees' needs ( ) ( ) ( ) ( )
Provided feedback on performance ( ) ( ) ( ) ( )
Was receptive to open communication ( ) ( ) ( )
( )
Followed company’s policies ( ) ( ) ( ) ( )
Page 1 of 3
6. How would you rate the following:
Excellent Good Fair Poor

Cooperation within your department/program ( ) ( ) ( )


( )
Cooperation with other departments ( ) ( ) ( ) ( )
Personal job training ( ) ( ) ( ) ( )
Equipment provided (materials, resources, facilities) ( ) ( ) ( )
( )
Company's performance review system ( ) ( ) ( ) ( )
Company's new employee orientation program ( ) ( ) ( )
( )
Rate of pay for your job ( ) ( ) ( ) ( )
Career development/Advancement opportunities ( ) ( ) ( )
( )
Physical working conditions ( ) ( ) ( ) ( )

Comments:

7. Was the work you were doing approximately what you expected it would be?

Yes No

Comments:

8. Was your workload usually: Too heavy ( ) About right ( )Too light ( )

9. How did you feel about the employee benefits provided by the company?

Excellent Good Fair Poor No Opinion

Medical/ healthcare plan ( ) ( ) ( ) ( ) ( )


Work Roster ( ) ( ) ( ) ( ) ( )
Others :
……………………… ( ) ( ) ( ) ( ) ( )
……………………… ( ) ( ) ( ) ( ) ( )

10. Would you recommend the company to a friend as a good organization to work
for?

Most definitely ( ) With reservations ( ) No ( )


Page 2 of 3
11. What suggestions do you have to make this company a better place to work?:

Human Resources Employee

Date: Date:

Page 3 of 3

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