Confidential Exit Interview
Employee Name: |
____________________________ |
Department: |
____________________________ |
Position: |
____________________________ |
Supervisor's Name: |
____________________________ |
Last Day of Employment: |
____________________________ |
Please rate the following reason/s that has/have been a factor in your decision to leave the company. Use 1 for the main reason, and descending numbers from there until all that apply have been accounted for. Leave choices that do not apply blank.
_______ Salary
_______ Benefits
_______ Scheduling conflicts
_______ Limited opportunities for advancement
_______ Family obligations
_______ Health condition
_______ Drive to work is too far
_______ Dislike work
_______ Pursuing my dream job
_______ Return to school
_______ Graduated from school
_______ Relocation
_______ Self-employment
_______ Inadequate training
_______ Supervisor difficult to work with
_______ Conflict with coworkers
_______ Other ______________
Page Two
If salary was your reason for leaving, what do you think would have been a fair salary for the position? Please explain.
_____________________________________________________________
Please answer “yes” or “no” to questions 3–11 and provide an explanation:
Do you feel that the employee benefits were adequate?
Yes □ No □
Please explain:
_____________________________________________________________
Do you feel that the company's paid time-off policy for holiday, vacation, and sick leave is adequate?
Yes □ No □
Please explain:
_____________________________________________________________
Is there a sense of teamwork among the managers and staff?
Yes □ No □
Please explain:
_____________________________________________________________
Were you ever harassed by a coworker, supervisor, or manager and did not report it?
Yes □ No □
Please explain:
_____________________________________________________________
Is the job that you performed what you expected it to be when you were hired?
Yes □ No □
Please explain:
_____________________________________________________________
Page Three
Do you feel that you were always treated fairly?
Yes □ No □
Please explain:
_____________________________________________________________
Do you feel that there was adequate communication among coworkers and other departments?
Yes □ No □
Please explain:
_____________________________________________________________
Did you receive recognition for a job well done?
Yes □ No □
Please explain:
_____________________________________________________________
Would you ever apply for a job here again in the future?
Yes □ No □
Please explain:
_____________________________________________________________
What did you enjoy most about your job?
_____________________________________________________________
What did you dislike most about your job?
_____________________________________________________________
Thank you for taking the time to answer our exit interview. Our employees are our most important asset and when someone decides to leave, it is helpful for us to know why in an effort to properly evaluate our goal of being a preferred employer in the community. We wish you well in your future endeavors and thank you for being part of our team.
