EXIT INTERVIEW FORM
Employee Name : Position :
Last Date of
:
Employment
What are the reasons for leaving?
Select one or more:
Higher pay Better benefits Better career opportunity
Conflict with other employees Conflict with superior Job/Position mismatch
/ Closer to home Other, please specify _______________________________
Please rank the following:
The Job itself Strongly Disagree Agree Strongly
Disagree Agree
- Job was challenging /
- Sufficient opportunities for advancement /
- Workload was manageable /
- Sufficient resources and staff were available /
- Colleagues appreciated your suggestions /
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- Your skills were effectively used /
- Adequate training and development programs /
What do you think can be improved about the job?
1. To have more organised, dedicated and structured project team members so that we won’t overlook on
tasks
2. To provide essential technical training/program for young engineer
3. To have experienced lead/HOD for each discipline who has an overview of all projects and can
provide advice whenever needed.
Remuneration, Benefits and Environment Strongly Disagree Agree Strongly
Disagree Agree
Salary is adequate in relation to responsibilities /
Wages were paid on time /
Other benefits were good /
Work-life balance was promoted and practiced /
What improvements, other benefits could the company offer?
1. To revisit salary, increment.
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DE-IMS-HR-FM-012 REV 01 [23.07.2018]
EXIT INTERVIEW FORM
Was the induction helpful and was it accurate /
Good and positive environment to work in /
Adequate equipment to do the work /
Got on well with other staff within the company /
There were sufficient staff to cover the work /
Internal communication worked well /
There was no bullying or harassment /
There are adequate parking facilities /
The business did not discriminate against any /
employee
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What do you think can be improved about the working environment and the Company?
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Supervisor / Line Manager/ Management Strongly Disagree Agree Strongly
Disagree Agree
Gave fair and equal treatment /
Was available to discuss job related issues /
Had sufficient knowledge of the job /
Is experienced in supervision /
Was open to suggestions /
Recognised and acknowledged achievements /
Acknowledged employees contributions /
Offered and promoted ways to develop /
Provided constructive feedback /
Clearly communicate management decisions /
Maintained a professional relationship with you /
What are your suggestions or improvements to your Supervisor
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EXIT INTERVIEW FORM
Completed by Received by (HRA Department)
Name: Name/Position:
Date: Date:
EXIT INTERVIEW FORM
