Exit Interview Form

Structured form for collecting employee feedback during an exit interview, including reasons for leaving, workplace experience, suggestions, and rehire eligibility.

Employee Information

• Employee Name
• Employee ID
  Optional if HR already has your offboarding record linked.
• Department
• Manager Name
  Optional. Used only to route feedback for internal review.
• Exit Interview Date

Reason for Leaving

• Type of Departure
• Primary Reason for Leaving
• Please specify the primary reason
• Were there any other factors in your decision?
• When did you first start considering leaving?

Workplace Experience

• Overall, how satisfied were you with your experience at the company?
• My role and expectations were clear
• I received the support I needed from my manager
• My workload was manageable
• What did the company do well?
• What were the biggest challenges in your role or work environment?

Suggestions for Improvement

• Which areas should the company improve?
• Please specify other improvement areas
• What could the company have done to retain you?
• Would you recommend this company as a place to work?

Rehire Eligibility and Follow-Up

• Would you be eligible for rehire?
• Would you consider returning to the company in the future?
• What would need to change for you to return?
• May HR contact you for follow-up questions?
  By selecting this, you consent to HR using your contact details only for exit interview follow-up.
• Preferred Contact Email