EXIT INTERVIEW PDF - Edited 08 Feb 17

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__________________________________________

EXIT INTERVIEW

Name : Employee No :
Designation : Department :
Date Joined : Last working Day:

Please select the appropriate respond with your sincerity to assist us in maintaining a better
working environment.

All comments will be viewed with private and confidential and will not affect your future
employment opportunities.

1 Very Poor
2 Poor
3 Good
4 Excellent

Please rate the following aspects of the job you are vacating. Use the 1 – 4 scale as stated above:

1 2 3 4
1. Satisfaction of Work Very Poor Good Excellent
Poor

a Type of Work Performed

b Fairness of Workload

c Salary

d Working Conditions

e Tools & Equipment Provided

f Training Received

g Co-workers

h Supervision Received

i Level of input in decision that affected you

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1 2 3 4
2. Company’s Performance Very Poor Good Excellent
Poor

a Recruitment process

b New employee orientation

c Training opportunities

d Career development opportunities

e Employee morale

f Fair treatment for employees

g Recognition for a job well done

h Support of work-life balance

i Cooperation within the department

j Communication between Management and


employees

k Performance and development planning and


evaluation

l Interest and investment in employees

m Commitment to customer service

n Concern with quality and excellence

o Administrative policies/procedures

1 2 3 4
3. Supervisor’s Aspect Very Poor Good Excellent
Poor

a Gave usable performance feedback

b Recognized accomplishments

c Clearly communicated expectations

d Treated you fairly and respectfully

e Coached, trained, & developed you

f Provided leadership

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g Encouraged teamwork & cooperation

h Resolved concerns promptly

i Listened to suggestions & feedback

j Kept employees informed

k Supported work-life balance

l Provided appropriate & challenging


assignments

Questions

1) What is your reason for leaving?

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2) What led you to accept your current position in our organization?

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3) Were your expectation of this job and this organizations met? If not, why?

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4) What would you suggest to Management to make our organizations a better place to work?

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5) Did you witness any violation of laws and policies during your employment with us?

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Employee’s comments:

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Employee’s Signature

………………………………………………
Name:
Staff ID:
Date:

Recorded by:

………………………………………………
Name:
Staff ID:
Date:

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