Exit Interview Questionnaire

Name*

Manager

Employment Date

Termination Date

Email*

What prompted you to seek alternative employment?

Type of Work
Quality of Supervision
Compensation
Work Conditions
Lack of Recognition
Family Circumstances
Company Culture
Career Advancement Opportunity
Other

Please Explain

Before making your decision to leave, did you investigate other options that would enable you to stay?

Yes
No

Please Describe

What did you think of your supervision regarding the following?

Demonstrated fair and equal treatment

Excellent
Good
Fair
Poor

Comments

Provided recognition on the job

Excellent
Good
Fair
Poor

Comments

Encouraged/listened to suggestions

Excellent
Good
Fair
Poor

Comments

Resolved complaints and problems

Excellent
Good
Fair
Poor

Comments

Followed policies and practices

Excellent
Good
Fair
Poor

Comments

Job Satisfaction

Excellent
Good
Fair
Poor

Comments

Training you received

Excellent
Good
Fair
Poor

Comments

Growth Potential

Excellent
Good
Fair
Poor

Comments

Was your workload usually

Too great
Varied, but all right
About right
Too light

Comments

How did you feel about your salary and the employee incentives?

Excellent
Good
Fair
Poor

Comments

Base Salary

Time-off

Other

Are there any other benefits you feel should have been offered?

Yes
No

Please Explain

Any other comments on benefits?

How would you rate the following in relation to your job?

Cooperation within your position

Excellent
Good
Fair
Poor

Comments

Cooperation with other team members

Excellent
Good
Fair
Poor

Comments

Communication with other team members

Excellent
Good
Fair
Poor

Comments

Communications within the company as a whole

Excellent
Good
Fair
Poor

Comments

Communications between you and your manager

Excellent
Good
Fair
Poor

Comments

Morale in your position

Excellent
Good
Fair
Poor

Comments

How frequently did you get performance feedback?

What were your feelings about the performance review process?

How frequently did you have discussions with your manager about your goals?

What did you like most about your job and/or this company?

What did you like least about your job and/or this company?

What does your new job offer that your job with this company does not?

Why is the new job/company better?

Do you have any suggestions for improvement? Have you raised them in the past?

Would you recommend this company to a friend as a place to work?

Yes, without reservations
Yes, with reservations
No

Additional comments about your job or this company