

Giving departing employees the chance to express their feelings about their work experience and your organization is a great way to identify hidden problems that may be impairing your recruitment and retention efforts, not to mention morale and productivity. Here’s a Questionnaire you can use as a template for your interview or have employees fill out online or manually if they can’t do an in-person interview.
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MODEL EXIT INTERVIEW QUESTIONNAIRE
Instructions
We’re asking you to complete this Questionnaire to find out why you’re leaving and what your experience at ABC Company was like. Our purpose is not to punish, pass blame or anything else negative; we just want to know what we’re doing right and wrong so we can do a better job of recruiting new people, retaining current employees and providing every person who works for us the most fulfilling and satisfying workplace and work experience possible.
So, please answer the questions candidly—tell us the truth, even if you think it’ll hurt our feelings.
Be assured that we’ll keep your responses strictly confidential and not disseminate or disclose them to anybody except our internal HR/management team for the narrow purpose of evaluating the effectiveness of our recruitment and retention efforts.
Please answer the following questions:
- Why are you leaving ABC Company?
- What, if anything, could we have done to keep you from leaving?
- What was the best part of your job?
- What was the worst part of your job?
- If a friend or family member was looking for a job, would you recommend ABC Company? Why or why not?
Please complete the following by putting a check in the box indicating whether you agree or disagree with the particular statement and to what degree:
STATEMENT | AGREE OR DISAGREE | |||
Strongly Disagree | Disagree | Agree | Strongly Agree | |
My job was satisfying | ||||
My skills and experiences were used effectively | ||||
My opinions were recognized, respected and appreciated | ||||
I was given the chance to grow professionally and as a person | ||||
I got the support and resources necessary to succeed | ||||
I understood what was expected of me | ||||
The expectations were fair and reasonable | ||||
My supervisor treated me fairly | ||||
My contributions were recognized | ||||
I was paid fairly | ||||
I was satisfied with the benefits package | ||||
The work environment was positive and professional | ||||
I wasn’t harassed, bullied or subjected to undue stress | ||||
ABC Company policies were clear and easy to understand |
Please use the space below to elaborate on any of the above responses or tell us anything else that will help us improve:
Thank you for completing this Questionnaire and best of luck in your next job and beyond. We’ll miss you!