Sample Employee Exit Interview Form
TO: _________________________________________________________________
FROM: ______________________________________________________________
I would appreciate it if you would take a few minutes to respond to the questions below. All answers will be held in strict confidence. Thank you.
How long were you employed? ___________________________________________
Job classification? ______________________________________________________
Why are you leaving? ___________________________________________________
Would you describe your working relationship (with respect to both your particular job and your relationship with fellow workers) as pleasant or unpleasant?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Do you feel that your particular job was important and significant in the overall operation of the business?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Are there any particular practices or working conditions that either led to your decision to resign or that you feel are detrimental to a satisfactory working relationship? If so, have you any suggestions on how to eliminate them?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Are there any particular practices or working conditions that you feel are particularly beneficial to an effective working relationship and that should be maintained?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Would you care to make any other comments?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Signed: _______________________________________________________________
Date: _________________________________________________________________
Reprinted with permission. © CCH
Sample Employee Exit Interview Form
Sample Employee Exit Interview Form
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