EXIT INTERVIEW SURVEY
[Insert Company Logo/Name]
[Insert Company Address]
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IMPORTANT. This exit interview survey will provide the company an opportunity to gather valuable feedback that will help improve work practices inside the company. We highly recommend your honesty upon answering this survey. The information collected will be utilized to improve employee retention strategies of [Specify Company Name]. Your response to this survey will be treated with utmost confidentiality and will not become part of your employee record.
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[Specify Date of Resignation]
Date of Resignation
Name: [Specify the Name Here]
Job Title: [Specify the Job Title Here]
Department: [Specify the Department Here]
Date of Hire: [Specify the Date Here]
Name of Supervisor: [Specify the Name Here]
PURPOSE OF SEPARATION
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Personal Reasons |
Dissatisfied with Working Conditions |
Dissatisfied with Pay |
Career Change |
Retirement |
Laid Off |
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Strongly Disagree |
Disagree |
Neutral |
Agree |
Strongly Agree |
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Satisfied with the recruitment process |
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Satisfied with the employee morale |
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Satisfied with the new employee orientation |
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Satisfied with the communication between the management and employees |
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Satisfied with the employee treatment |
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Satisfied with the company’s goals and objectives |
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Satisfied with the benefits |
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Satisfied with the salary |
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Satisfied with the company’s goals and objectives |
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Satisfied with the career growth opportunities |
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Satisfied with the type of work |
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Satisfied with coworkers and management |
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Satisfied with the working hours |
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Satisfied with the company policies and regulations |
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Satisfied with the performance recognition |
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Satisfied with the workload |
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Satisfied with the level input of decision |
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Satisfied with the working conditions |
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Satisfied with the training and development |
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Satisfied with the tools and equipment provided |
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Satisfied with the work location |
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Based on your complete experience with our organization, are you likely to recommend your family/friends to work with us?
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What actions do you think the company should take establish a better workplace?
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Do you have any more comments / suggestions you want to share to the company?
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Employee Signature
