Name: Date:
Job Title: Department:
Hire Date: Separation Date:
Reason for Leaving (Voluntary/Involuntary):
1. Did you feel sufficiently trained and oriented for your job?
Please comment:
2. Did you feel that you were treated with respect & responsibility by co-employees and management?
Please comment:
3. Do you feel that you could have done your job better if you were provided different or better resources? What resources would you have needed?
Please comment:
4. Did you feel free to discuss suggestions or problems with your supervisor or manager?
Please comment:
5. Did your supervisor or manager provide you with clear instructions and expectations?
Please comment:
6. Were any employees given preferential treatment or discriminated against?
Please comment:
7. Did you witness or have knowledge of any unethical or illegal acts or practices engaged in by any employees of this company?
Please comment:
8. Do you have any suggestions for improving company management?
Please comment:
8. Do you have any suggestions for improving the quality of our goods or services?
Please comment:
1. Do you have any suggestions for improving communication in this company?
Please comment:
2. Do you have any suggestions for improving customer relations in this company?
Please comment:
3. Do you have any suggestions for improving employee motivation in this company?
Please comment:
4. Do you have a new job that you expect to begin within the next few weeks? With whom? What does that company offer you that this company didnt?
Please comment:
I have returned, or arranged for the return of, all company property, including, but not limited to, computers, software, documents, financial records, personnel files, equipment and tools, vehicles, credit cards, keys, security cards, parking passes, works in progress, client or customer lists, books, resource materials, and confidential or trade secret items.
Signature Date
Forwarding Address:
Interview performed by:
Name: Title:
Department: Date:
Let me know if it works for you
Regards,
Hassan