Exit Interview Form
Employee Information:
● Name:
● Last Working Day:
● Position:
● Department:
● Manager's Name:
1. Reasons for Leaving:
☐ Better opportunity elsewhere
☐ Relocation
☐ Career change
☐ Dissatisfaction with role/responsibilities
☐ Dissatisfaction with company culture
☐ Personal reasons
☐ Retirement
☐ Other (Please specify):
2. Overall Experience:
❖ How would you rate your overall experience working with the company? (1-5, 5 being the highest)
□ Rating:
□ Comments:
❖ What did you enjoy most about working here?
❖ What aspects of your job or the company could be improved?
3. Job Role and Responsibilities:
4. Did your job role match the expectations set during the hiring process?
● Yes
● No
● Comments:
5. Were you provided with adequate resources and support to perform your job effectively?
● Yes
● No
● Comments:
6. How would you describe the work environment and company culture?
7. Were there any specific instances or aspects of the work environment that contributed to your
decision to leave?
8. How effective was your communication with your immediate supervisor/manager?
● Very Effective
● Somewhat Effective
● Ineffective
● Comments:
9. Were your professional development needs addressed and supported by the company?
● Yes
● No
● Comments:
10. What suggestions do you have that might improve the company’s performance, employee
satisfaction, or work processes?
11. Do you have any additional comments or feedback you would like to share?
Confidentiality Note:
Your responses in this exit interview will be kept confidential and used solely for the purpose of improving our
organization. Your feedback is valuable to us, and we appreciate your honesty.
Thank you for taking the time to complete this exit
interview. Signature:
Date: