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7.exit Interview Form

This document contains an exit interview form used to gather information from employees leaving their current position. The form collects details about the employee such as name, department, position, and manager. It asks the employee to indicate the main reason for leaving such as personal reasons, dissatisfaction with various job aspects, retirement, or new career opportunities. Additional questions inquire about personal, work-related, pay/benefit factors that influenced the decision. The employee is asked to rate various aspects of the organization and provide suggestions for improvement. Finally, it collects information on the employee's future plans upon leaving.

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198 views2 pages

7.exit Interview Form

This document contains an exit interview form used to gather information from employees leaving their current position. The form collects details about the employee such as name, department, position, and manager. It asks the employee to indicate the main reason for leaving such as personal reasons, dissatisfaction with various job aspects, retirement, or new career opportunities. Additional questions inquire about personal, work-related, pay/benefit factors that influenced the decision. The employee is asked to rate various aspects of the organization and provide suggestions for improvement. Finally, it collects information on the employee's future plans upon leaving.

Uploaded by

piyushkedia00123
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Exit Interview Form

Name: Employment Date:


Department: Separation Date:
Current Position: Reporting Manager:

Section I-Reason for Separation (Required)


Please indicate the main reason(s) you are leaving your current position?

Retirement
Personal Dissatisfied with Dissatisfied Dissatisfied with promotion Career Job did not meet Private Sector
Reason work condition with Pay or growth opportunities Range expectation employment

Section II-Personal Factor Contributing to Resignation (Optional)


Please indicate the following factor that influenced your decision to leave (Check all that applies)
Health Reason Family Reason Child-Care
Relocating Career Change Commute/Transportation
Higher Studies Marriage Other

Section III-Work/Job Factor Contributing to Resignation (Optional)


Please indicate the following factor that influenced your decision to leave (Check all that applies)
Dissatisfaction with type of work Dissatisfaction with working conditions
Dissatisfaction with level of input in decision Dissatisfaction with training and development received
Dissatisfaction with co-workers/teamwork Dissatisfaction with supervision received
Dissatisfaction with working hours Dissatisfaction with promotional opportunities
Dissatisfaction with company policies Dissatisfaction with work location
Dissatisfaction with lack of recognition Dissatisfaction with lack of organization value

Section IV-Pay/Benefit Factors Contributing to Resignation (Optional)


Please indicate the following factor that influenced your decision to leave (Check all that applies)
Salary Retirement Benefit Plan
Leave Benefit Flexible Benefit Options
Healthcare Options Support of work-life balance

Section V-Overall rating of Organization


How would you rate the following aspect of the overall organization? (Use the scale 1- lowest & 5-highest)
1 2 3 4 5 1 2 3 4 5
Recruitment process Career development Opportunities
Training opportunities Fair treatment of employee
Employee morale Communication with management
Recognition for a job well done Interest and investment in employees
Performance management Process Concern with quality and excellence
Commitment to customer service Culture

As per you, What are the “pros” of working with Ethos?

Do you have any suggestions for how the company can improve in the processes or working environment/culture?
Exit Interview Form
What are your future plans? / What are you planning next? (If he/she is joining some other company – Would you feel
comfortable telling us where you are going and why you decided to join them?)

Would you like to recommend Ethos to your friend as a good place to work?

Yes: No: May be:

Interviewer’s Signature :

Exiting Employee’s Signature :

Date of Exit Interview :

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