Exit Interview Form
Print Form
General Information
Termination Date
Interview Date
Employee Name
Employee Email
Employee Phone
Job Title
Duration of Employment
Manager Name
Manager Email
Manager Phone
Mode of Interview
In Person
Phone
Video Call
Email
Type of Termination
Voluntary
Involuntary
Judicial Decision
Other
Section 1: Employee Questions
Overall Work Experience
Very Satisfactory
Satisfactory
Neutral
Unsatisfactory
Very Unsatisfactory
Compensation and Benefits
Very Adequate
Adequate
Neutral
Inadequate
Very Inadequate
Development and Career Opportunities
Very Sufficient
Sufficient
Neutral
Insufficient
Very Insufficient
Work-Life Balance
Excellent
Good
Neutral
Poor
Very Poor
Reasons for Leaving
Additional Comments
Section 2: Manager Questions
Employee Performance Rating
Exceeds Expectations
Meets Expectations
Partially Meets Expectations
Does Not Meet Expectations
Level of Contribution
High
Moderate
Low
No Significant Contribution
Reasons for Leaving (Manager's Perspective)
Suggestions for Organizational Improvement
Section 3: HR Questions
Potential Retention Improvements
Final Comments on Departure
Rate Your Experience
We’re sorry to hear your experience was not satisfactory. Please share any comments or suggestions on how we can improve:
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