Free Sample Exit Interview Form
download free sample human resources policies and job descriptions

Sample Exit Interview Form


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Exit Interview Form

 

Employee Name ____________________________          Department_____________________ 

 

Position ___________________________________          Separation Date__________________ 

 

Reason for Termination:

 

__Involuntary

__Voluntary

__Lay Off

__Personal Reasons

__Position Eliminated

__Took Another Position

__Attendance

__Retirement

__Reorganization

__Relocating

__Violation of Company Policy

__Returning to School

__Other

 

 

Questionnaire 

 

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? 

____________________________________________________________________________

 

____________________________________________________________________________

 

____________________________________________________________________________

 

 

Comments

 

Employee Comments:

____________________________________________________________________________

 

____________________________________________________________________________

 

____________________________________________________________________________

 

 

Interviewer Comments:

____________________________________________________________________________

 

____________________________________________________________________________

 

____________________________________________________________________________

 

 

Is this employee eligible for rehire?        __Yes               __ No

 

Other: _________________________ 

 

 

 

Employee's Signature _____________________________________ Date _________________ 

 

 

 

Interviewer's Signature ____________________________________ Date _________________

 

Form provided by: IRM      e-mail


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