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C O M P AN Y N A M E

COMPANY LOGO

Exit Interview
Your opinion is important to us.
Name: _________________________________ Supervisor: ______________________________
Department: ________________________

Position: ______________

Emp ID: _______

Date of Joining: ___________________

Date of Confirmation: ___________________

Personal
Reason

Compensation
& Benefits

1.

Why are you leaving the company?

2.

Please explain your reason(s) for leaving in more detail.

3.

What circumstances would have prevented your departure?

4.

What did you like most about your job?

5.

What did you like least about your job?

6.

What did you think of your supervisor on the following points:


Criterion

Below
Expectati
on

Quality of
Supervision

Work
Environment

Meets
Expectatio
ns

Role
Model

Consistently Fair
Provides recognition
Resolve complaints
Sensitive to employee needs
Provides feedback on
performance
Friendly to open
communication
Follows company policies

7.

What Suggestions do you have for our improvements?

8.

If we implemented those suggestions, would you return to work here?

Yes

No

9.

Would you recommend this company to your friends as a good place to work?

Yes

No

10.

In this section, departing


employee will rate the following
statements:

Strongl
y
disagre
e

Somewha
t
disagree

Somewha
t
agree

Strongl
y
agree

Do you believe that you were treated like a


valuable member of the company?

Personal
Reason

Compensation
& Benefits

1.

Why are you leaving the company?

2.

Please explain your reason(s) for leaving in more detail.

3.

What circumstances would have prevented your departure?

4.

What did you like most about your job?

5.

What did you like least about your job?

6.

What did you think of your supervisor on the following points:


Criterion

Below
Expectati
on

Quality of
Supervision

Work
Environment

Meets
Expectatio
ns

Role
Model

Consistently Fair
Provides recognition
Resolve complaints
Sensitive to employee needs
Provides feedback on
performance
Friendly to open
communication
Follows company policies

7.

What Suggestions do you have for our improvements?

8.

If we implemented those suggestions, would you return to work here?

Yes

No

9.

Would you recommend this company to your friends as a good place to work?

Yes

No

10.

In this section, departing


employee will rate the following
statements:

Strongl
y
disagre
e

Somewha
t
disagree

Somewha
t
agree

Strongl
y
agree

Do you believe that you were treated like a


valuable member of the company?

Personal
Reason

Compensation
& Benefits

1.

Why are you leaving the company?

2.

Please explain your reason(s) for leaving in more detail.

3.

What circumstances would have prevented your departure?

4.

What did you like most about your job?

5.

What did you like least about your job?

6.

What did you think of your supervisor on the following points:


Criterion

Below
Expectati
on

Quality of
Supervision

Work
Environment

Meets
Expectatio
ns

Role
Model

Consistently Fair
Provides recognition
Resolve complaints
Sensitive to employee needs
Provides feedback on
performance
Friendly to open
communication
Follows company policies

7.

What Suggestions do you have for our improvements?

8.

If we implemented those suggestions, would you return to work here?

Yes

No

9.

Would you recommend this company to your friends as a good place to work?

Yes

No

10.

In this section, departing


employee will rate the following
statements:

Strongl
y
disagre
e

Somewha
t
disagree

Somewha
t
agree

Strongl
y
agree

Do you believe that you were treated like a


valuable member of the company?

Personal
Reason

Compensation
& Benefits

1.

Why are you leaving the company?

2.

Please explain your reason(s) for leaving in more detail.

3.

What circumstances would have prevented your departure?

4.

What did you like most about your job?

5.

What did you like least about your job?

6.

What did you think of your supervisor on the following points:


Criterion

Below
Expectati
on

Quality of
Supervision

Work
Environment

Meets
Expectatio
ns

Role
Model

Consistently Fair
Provides recognition
Resolve complaints
Sensitive to employee needs
Provides feedback on
performance
Friendly to open
communication
Follows company policies

7.

What Suggestions do you have for our improvements?

8.

If we implemented those suggestions, would you return to work here?

Yes

No

9.

Would you recommend this company to your friends as a good place to work?

Yes

No

10.

In this section, departing


employee will rate the following
statements:

Strongl
y
disagre
e

Somewha
t
disagree

Somewha
t
agree

Strongl
y
agree

Do you believe that you were treated like a


valuable member of the company?

Personal
Reason

Compensation
& Benefits

1.

Why are you leaving the company?

2.

Please explain your reason(s) for leaving in more detail.

3.

What circumstances would have prevented your departure?

4.

What did you like most about your job?

5.

What did you like least about your job?

6.

What did you think of your supervisor on the following points:


Criterion

Below
Expectati
on

Quality of
Supervision

Work
Environment

Meets
Expectatio
ns

Role
Model

Consistently Fair
Provides recognition
Resolve complaints
Sensitive to employee needs
Provides feedback on
performance
Friendly to open
communication
Follows company policies

7.

What Suggestions do you have for our improvements?

8.

If we implemented those suggestions, would you return to work here?

Yes

No

9.

Would you recommend this company to your friends as a good place to work?

Yes

No

10.

In this section, departing


employee will rate the following
statements:

Strongl
y
disagre
e

Somewha
t
disagree

Somewha
t
agree

Strongl
y
agree

Do you believe that you were treated like a


valuable member of the company?

Additional Comments and Suggestions are encouraged.

Interviewer:
Name

Interviewee:
:

Sign & Date :

Name

Sign & Date :

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