Title Page

  • Employee Name (Last, First, Middle)

  • Position

  • Conducted on

  • Exit Interview Conducted By:

  • Location

Exit Interview / Survey

  • Why are you leaving?

  • Please specify

  • Was there a specific event of an issue that prompted your resignation?

  • Please briefly explain

  • Did you discuss this matter with your supervisor / manager?

  • Were you comfortable talking to your manager about work problems?

  • Did you feel you were kept up to date on new developments and company policies?

  • Were you given the tools to succeed at your job?

  • What did you like most about your job? And what would you change about it?

  • How likely are you to recommend working with our organization to your friends or family members?

  • Why or why not?

  • Are there any other unresolved issues or additional comments?

  • What could we have done better?

COMPLETION

  • Name & Signature of Employee

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.