HMR | Exit Interview Page 1 of 2

Exit Interview Form

Employee Name Employee ID
Job Title District
Date of Hire Date of last day

Company Property Outstanding Advance / Report

1. How long were you in your most recent role (please thick)
□ More than 5 years
□ More than 2 years, but less than 5 years
□ More than 1 year, but less than 2 years
□ Less than 1 year

2. Please indicate in order of importance your main reasons for leaving your present post using
the box(es) below:
□ Domestic Commitment □ Lack of Communication
□ Ill Health □ Lack of Training
□ Hours □ Pay
□ Low Job Satisfaction □ Working Conditions
□ Workload/Stress □ Poor Career Prospects
□ Sex/Race discrimination □ Maternity
□ Early Retirement □ End of Contract
□ Retirement □ Temporary Contract Status
□ Personal Reasons

3. How would you rate communication within your department? (please thick)
□ Excellent □ Satisfactory
□ Good □ Poor

4. How would you rate communication within this company? (please thick)
□ Excellent □ Satisfactory
□ Good □ Poor

5. How could communication be improved?

______________________________________________________________________________

Rev. 1.0, 30 September 2019

HMR | Exit Interview Page 2 of 2

______________________________________________________________________________
6. How would you rate the training provided to do the job? (please thick)
□ Excellent □ Satisfactory
□ Good □ Poor
7. How could training be improved?
______________________________________________________________________________
______________________________________________________________________________

8. How could training be improved?

______________________________________________________________________________
______________________________________________________________________________

9. What did you enjoy most about your present job?

______________________________________________________________________________
______________________________________________________________________________

10. What would you change about your present post, given the opportunity? (other than salary)
______________________________________________________________________________
______________________________________________________________________________

11. How would you rate the training provided to do the job? (please thick)
□ At a higher salary
□ On the same salary
□ At a lower salary

12. Please provide details of your new remuneration package if happy to do so

______________________________________________________________________________
______________________________________________________________________________

13. Please provide any other comments on any aspect of your present post, or the Company which
you wish to make:
______________________________________________________________________________
______________________________________________________________________________

The HR Department may contact you to discuss your comments further, would this be acceptable?
□ YES
□ NO

Thank you for completing the questionnaire

Rev. 1.0, 30 September 2019