Employee Exit Interview Questionnaire
Please complete this questionnaire to help us improve our workplace for current and future employees.
Full Name
*
First Name
Last Name
Job Title/Position
*
Last Working Day
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How long have you worked with our company?
*
Please Select
Less than 6 months
6 months to 1 year
1-2 years
More than 2 years
What is your primary reason for leaving?
*
Better job opportunity
Personal reasons
Relocation
Dissatisfaction with pay/benefits
Work environment
Management/supervision
Other
Please rate the following aspects of your employment experience:
*
Rows
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Training received
1
2
3
4
5
Support from management
6
7
8
9
10
Workload
11
12
13
14
15
Quality of equipment/supplies
16
17
18
19
20
Work environment
21
22
23
24
25
How would you rate your overall experience working at our company?
*
1
2
3
4
5
Would you recommend our company as a good place to work?
*
Yes
No
What did you like most about your job?
What could we improve to make this a better workplace?
Any additional comments or suggestions?
Submit Exit Interview
Should be Empty: