Employee Exit Interview Form

Employee Information

Employee Name: _________________________________________________

Position: _________________________________________________

Department: _________________________________________________

Supervisor: _________________________________________________

Date of Interview: ___________________________________________

Last Working Day: ____________________________________________

(Please check all that apply and elaborate if needed)

· _______ New Job Opportunity

· _______ Career Change

· _______ Relocation

· _______ Health Reasons

· _______ Personal Reasons

· _______ Retirement

· _______ Dissatisfaction with Role

· _______ Dissatisfaction with Compensation/Benefits

· _______ Other: _________________________________________________

Further Explanation:

_________________________________________________________________________

How would you describe your overall experience with the company?

_________________________________________________________________________

What did you enjoy most about your role?

_________________________________________________________________________

What aspects of the job were most challenging or least satisfying?

_________________________________________________________________________

Did you feel supported in your role by management and colleagues?

_________________________________________________________________________

Were there sufficient opportunities for growth and development?

_________________________________________________________________________

What could we have done to improve your experience?

_________________________________________________________________________

Are there any changes you would suggest to enhance the workplace environment?

_________________________________________________________________________

Would you recommend this company as a workplace to others? (Yes ___ No ___)

_________________________________________________________________________

Comments: _________________________________________________

_________________________________________________________________________

Is there anything else you would like us to know?

_________________________________________________________________________

Interviewer's Name: _________________________________________________

Position: _________________________________________________

Signature: ______________________________ Date: __________________