Exit Interview Form
Employee Name ____________________________ Department_____________________
Position ___________________________________ Separation Date__________________
Reason for Termination:
__Took Another Position
__Violation of Company Policy
__Returning to School
What is your primary reason for leaving? If multiple, please specify.
Would you consider returning to work for this company in the future?
What did you find most satisfying about your job?
What did you find the most frustrating about your job?
Were there any company procedures or policies that made your job more difficult?
Would you recommend this company to a colleague or friend as a good place to work?
Is there anything that the company or your manager could have done to prevent you from leaving?
Do you have any suggestions for how the company can improve satisfaction in your position?
Is this employee eligible for rehire? __Yes __ No
Employee's Signature _____________________________________ Date _________________
Interviewer's Signature ____________________________________ Date _________________
Form provided by: IRM e-mail