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  • Employee Exit Interview Form

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    Joanna Michelle Vidas
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    The document is an exit interview form for employees leaving the Department of Health Central Visayas Center. It collects information about the employee's reasons for leaving such as accepting other employment, health concerns, or relocation. It asks about what initially attracted them to working at DOH and what they liked and disliked about their employment experience. The form also has the employee rate their level of agreement on statements about their working relationships, training, workload, understanding of duties, working conditions, pay, benefits, and overall satisfaction. Space is provided for additional comments.

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    Original Title

    EMPLOYEE EXIT INTERVIEW FORM

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    The document is an exit interview form for employees leaving the Department of Health Central Visayas Center. It collects information about the employee's reasons for leaving such as accepting other employment, health concerns, or relocation. It asks about what initially attracted them to working at DOH and what they liked and disliked about their employment experience. The form also has the employee rate their level of agreement on statements about their working relationships, training, workload, understanding of duties, working conditions, pay, benefits, and overall satisfaction. Space is provided for additional comments.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    7 views2 pages

    Employee Exit Interview Form

    Uploaded by

    Joanna Michelle Vidas
    The document is an exit interview form for employees leaving the Department of Health Central Visayas Center. It collects information about the employee's reasons for leaving such as accepting other employment, health concerns, or relocation. It asks about what initially attracted them to working at DOH and what they liked and disliked about their employment experience. The form also has the employee rate their level of agreement on statements about their working relationships, training, workload, understanding of duties, working conditions, pay, benefits, and overall satisfaction. Space is provided for additional comments.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 2

    DOH Central Visayas Center for Health Development

    Human Resource Management Office

    EMPLOYEE EXIT INTERVIEW FORM

    LAST NAME / FIRST NAME / MIDDLE INITIAL

    POSITIONEFFECTIVE DATE OF RESIGNATION

    DIVISION SECTION

    1. What was your main reason for leaving DOH?

    Health Concerns Accept Other Employment To Continue Education

    Relocation Family Needs/Responsibilities Manage Own/Family Business

    Others (Please state) _______________________________________________________________

    _______________________________________________________________

    a. If one of your reasons for leaving is “Relocation”, please specify the reason.

    Going Abroad to (Country)

    To relocate with spouse / family

    Others (Please state) _______________________________________________________________

    _______________________________________________________________

    b. If your reason for leaving is “To Accept Other Employment”, please specify the reason(s).
    Please check all applicable.

    Promotion/Career Advancement Distance To/From Work

    Work Schedule Better Benefits Better Pay Career Change

    Others (Please state) ______________________________________________________________

    ______________________________________________________________

    2. What attracted you to work for DOH?

    3. What did you like most about your employment experience at DOH?

    _____________________________________________________________________________________

    1
    4. What did you like least about your employment experience at DOH?

    Please mark your choice with a check mark:

    Strongly Agree Disagree Strongly


    Agree Disagree

     I had a good working relationship with 4 3 2 1


    co-employees

     I had a good working relationship with my 4 3 2 1


    supervisor

     Training or job development met 4 3 2 1


    expectations.

     Work load/demands were manageable. 4 3 2 1

     I had a clear understanding of my job duties. 4 3 2 1

     Working conditions met expectations. 4 3 2 1

     Pay was fair for the amount of work required. 4 3 2 1

     The benefits were competitive. 4 3 2 1

     My work schedule met my needs. 4 3 2 1

     My supervisor’s management style is 4 3 2 1


    effective.

     Advancement opportunities are easy to 4 3 2 1


    achieve.

     Overall, I was satisfied with my job. 4 3 2 1

    Use the space provided below for additional comments you may have on any of the areas you have
    just rated.

    _______________________ _______________
    Employee’s Signature Date

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