Employee Exit Interview Form

Date: __________________________

Conducted By: ______________________________________________

Employee Interviewed: _______________________________________

  1. For what reason are you leaving?

    2.  

  2. What is your understanding of the events which have led to separation?
    (cover this if employee was subject to disciplinary procedure.)

    3.  

  3. What is your opinion of the supervision you received?

    4.  

  4. What did you like and dislike about <Company> and its policies?

    5.  

  5. What would you recommend <Company> change? How?

    6.  

  6. What is your opinion of working conditions at <Company>?

    7.  

  7. How do you feel about the pay? Benefits?

    8.  

  8. What is your opinion about the training you received?

    9.  

  9. Do you believe that appropriate opportunities for advancement were available?

    10.  

  10. Have you obtained a new job? Yes_____ No_____ If yes would you please tell us:

    11.  

Employer's name: _____________________________________________________

Address: ____________________________________________________________

Position title: _____________________________ Starting salary: _______________

11. What do you see as most attractive about the new job?

 

__________________________________ __________________________________
interviewee's signature employer's signature