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Exit Interview Form

The employee exit interview form collects information about an employee's reasons for leaving, ratings of their job and the organization, and their supervisor. It asks for feedback on challenges, resources, skills usage, workload, satisfaction, work environment, compensation, equipment, treatment, recognition, policies, communication, supervision style, and whether they would return or recommend the organization. The form concludes with an optional comments section for any additional feedback.

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mtcadslpalingcastre
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259 views2 pages

Exit Interview Form

The employee exit interview form collects information about an employee's reasons for leaving, ratings of their job and the organization, and their supervisor. It asks for feedback on challenges, resources, skills usage, workload, satisfaction, work environment, compensation, equipment, treatment, recognition, policies, communication, supervision style, and whether they would return or recommend the organization. The form concludes with an optional comments section for any additional feedback.

Uploaded by

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

Name of Employee : ____________________


Designation : ____________________
Date Hired : ____________________
Date Separated : ____________________

Reason/s for leaving:

Better Benefits/Compensation Return to School Closer to home

Career Opportunity Change of Career Family and/or personal


Issues with Co-workers/Management Work Conditions Others: ________________

Strongly Strongly
How would you rate the following in relation to your job? Disagree Agree
Disagree Agree
Job was challenging
Sufficient resources and staff were available
Skills were effectively used
Growth potential
Workload was manageable
Job satisfaction

How would you rate the following aspects of the Strongly Strongly
Disagree Agree
organization overall? Disagree Agree
Good and positive environment to work in
Competitive compensation/benefits
Had adequate equipment to do the work
Fair treatment of employees
Recognition for a job well done
Work-life balance was promoted and practiced
Follow policies and practices
Communication between management and employees
How would you rate your supervisor/immediate head on Strongly Strongly
Disagree Agree
the following factors? Disagree Agree
Acknowledge employee contributions
Provide constructive feedback
Recognize accomplishments
Demonstrate fair and equitable treatment
Provide feedback on your job performance
Encourage teamwork & cooperation
Listen to suggestions & feedback
Resolve complaints and problems

Others: YES NO
I would consider re-applying to the organization in the future
I would feel comfortable recommending someone else to work here?

Do you have any other comments or suggestions you want to make?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

__________________
Employee’s Signature

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