Employee Exit Interview Survey
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
So, which department were you working?
Please Select
What was your job title?
Your start date and time
 -
Month
 -
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Your final date and time
 -
Month
 -
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Who was your manager?
And what are the most important reasons you for you leaving?
Not satisfied with supervisor
Office politics
Pay
Need to relocate
Wanted a career change
Family circumstances/personal reasons
Health reasons
Working conditions and/or benefits
Retirement
Workload
Going back to education
Next, you can rate your experience working here
1 means low agreement, 3 means high.
I've had the opportunity to use my skills to the fullest.
1
2
3
4
5
It's been clear what was required of me.
1
2
3
4
5
I've received enough training and support.
1
2
3
4
5
I've had enough resources to do my job well.
1
2
3
4
5
My work has been interesting and challenging.
1
2
3
4
5
Good work here is always recognized and appreciated.
1
2
3
4
5
There's been opportunities for career advancement.
1
2
3
4
5
Cooperation within the department has worked well.
1
2
3
4
5
Cooperation with other departments has worked well.
1
2
3
4
5
I've accomplished what I wanted with this job.
1
2
3
4
5
Overall, I'm happy I worked here.
1
2
3
4
5
We're sorry to hear you didn't really enjoy working here. Here's a chance to air your thoughts.
Any other comments on the office?
Next, let's talk about how you found your coworkers
My supervisor has good managerial skills.
1
2
3
4
5
My supervisor has been open to, and has acted on, my feedback.
1
2
3
4
5
My supervisor has enough technical knowledge.
1
2
3
4
5
Overall, the relationship with my supervisor has been fine.
1
2
3
4
5
My coworkers have enough technical knowledge.
1
2
3
4
5
Overall, my relationship with my coworkers has been fine.
1
2
3
4
5
Ok, now rate how you thought about the salary and benefits we offered.
Don't worry, we're getting towards the end now.
Starting salary
1
2
3
4
5
Ending salary
1
2
3
4
5
Vacation policy
1
2
3
4
5
Sick leave policy
1
2
3
4
5
Perks
1
2
3
4
5
And do you have some suggestions for us to improve in this area?
Submit
Should be Empty: