Employee Exit Interview Checklist Form

An employee exit interview checklist (also known as a termination checklist or an outplacement checklist) is a tool that aids in the efficient and painless execution of the exit interview process. It's best not to put it off because it could lead to confusion and poor decisions.

Questions for Employee Exit Interview Checklist Form

1.

Name

The answer should be a text input.
2.

Employment Date

The answer should be a date input.
3.

Department

The answer should be a text input.
4.

Position

The answer should be a text input.
5.

What prompted you to seek alternative employment?

The answer should be a multiple choice:
  1. Type of Work
  2. Quality of Supervision
  3. Compensation
  4. Work Conditions
  5. Lack of Recognition
  6. Family Circumstances
  7. Company Culture
  8. Career Advancement Opportunity
  9. Business/Product Direction
  10. None of them
6.

Before making your decision to leave, did you investigate other options that would enable you to stay? If "yes", describe or leave "no"

The answer should be a text input.
7.

What did you think of your supervision in regard to the following?

The answer should be a single (or) multiple choice by row and column:
Demonstrated fair and equal treatment
Provided recognition on the job
Developed cooperation and teamwork
Encouraged/listened to suggestions
Resolved complaints and problems
Followed policies and practices
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
8.

How would you rate the following in relation to your job?

The answer should be a single (or) multiple choice by row and column:
Cooperation within your department
Communications in your department
Cooperation with other departments
Morale in your department
Training you received
Extremely unlikely
Unlikely
Neutral
Likely
Extremely likely
9.

Rate your Job Satisfaction

The answer should be a rating.
10.

Was your workload usually

The answer should be a single choice:
  1. Too great
  2. Varied, but all right
  3. About right
  4. Too light
11.

Would you recommend this company to a friend as a place to work?

The answer should be a single choice:
  1. Yes, without reservations
  2. Yes, with reservations

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Employee Exit Interview Checklist Form

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