Exit Interview Form

EMPLOYEE EXIT INTERVIEW
PURPOSE

The intent of this Exit Interview is to ensure that any employee is informed of his/her rights, benefits, and the records are collected and maintained regarding the termination of employment.

POLICY
- To determine and discuss the employee’s reason for resignation, if applicable.
- To discover and discuss any misunderstandings the employee may have had about his/her job or with his/her manager.
- To maintain good will and teamwork amongst current and future employees
Employee Name

First NameLast Name
Job Title
Start Date

MonthDayYear
Separation Date

MonthDayYear
Total Length of Service
Reason for Leaving
REASONS FOR LEAVING
Have you accepted another position?
How would you describe management at our company? Do you feel they adequately recognize employee contributions?
When did you begin searching for another job?
What makes the new job more attractive than your current position?
What made you decide that your career goals could be better achieved elsewhere?
Have you spoken with anyone, either your director or any of the partners about your career goals?
In your opinion, have there been adequate career opportunities available within company?
If you selected other, please elaborate.
JOB SATISFACTION
Job Responsibilities

1

2

3

4

5

1 is Unsatisfactory, 5 is Outstanding
Opportunity for Achieving Goals

1

2

3

4

5

1 is Unsatisfactory, 5 is Outstanding
Work Environment

1

2

3

4

5

1 is Unsatisfactory, 5 is Outstanding
Director/ Manager

1

2

3

4

5

1 is Unsatisfactory, 5 is Outstanding
Pay

1

2

3

4

5

1 is Unsatisfactory, 5 is Outstanding
Benefits

1

2

3

4

5

1 is Unsatisfactory, 5 is Outstanding
What did you enjoy most about your job?
What did you enjoy least about your job?
What makes the company a poor place to work?
What recommendation would you have for making the company as a whole a better place to work?
Would you have stayed if a more satisfactory arrangement could have been worked out?
Please sign and date this form below authorizing the placement of this Exit Interview form within your personal file.
Date

MonthDayYear
Signature
Should be Empty:

EMPLOYEE EXIT INTERVIEW

REASONS FOR LEAVING

JOB SATISFACTION