Business OS
Human ResourcesTermination & Exit

Exit Interview Questionnaire

Structured exit interview to capture insights from departing employees.

Updated 26d ago
terminationexit-interviewretention

{{company_name}}

{{company_address}}

Phone: {{phone}} | Email: {{email}} | Web: {{website}}

Employee Information

FieldDetail
Name{{employee_name}}
Position{{position}}
Department{{department}}
Start Date{{start_date}}
Last Day{{last_day}}
Reason for Leaving{{reason}}

Reasons for Departure

  • Better compensation elsewhere
  • Career growth opportunity
  • Work-life balance
  • Relationship with manager
  • Company culture
  • Job content or scope
  • Relocation
  • Personal or family reasons
  • Other

Rating Your Experience

Area1 (Poor)2345 (Excellent)
Onboarding & training
Compensation & benefits
Career development opportunities
Quality of management
Team collaboration
Tools & resources
Company culture

Open Feedback

What did you enjoy most about working at {{company_name}}?

What could we improve to retain talent like you?

Would you recommend {{company_name}} as an employer? Why or why not?

Acknowledgement & Signatures

By signing below, both parties confirm they have read, understood, and agreed to the terms of this document.

Signed
Date

Grounds & Effective Date

FieldValue
Employee{{employee_name}} ({{employee_id}})
Role{{job_title}}, {{department}}
Last Working Day{{effective_date}}
Notice PeriodAs per employment contract
Reason CategoryResignation / Mutual / Redundancy / Cause
Issuing Manager{{manager_name}}

Final Settlement

ItemAmount / Status
Salary up to Last Working Day
Accrued and Unused Leave
Pro-rated Bonus (if applicable)
End-of-Service / Gratuity
Outstanding Loans / Advances
Net Final Payment

Exit Checklist

Continuing Obligations

  1. Confidentiality obligations as set out in the employment contract continue indefinitely.
  2. Any non-solicitation and non-compete clauses remain enforceable as agreed.
  3. Intellectual property assignments remain in full force.
  4. The Employee will not represent themselves as acting on behalf of the Company after the last working day.

Right of Appeal

Where this letter relates to a termination for cause, the Employee may submit a written appeal within seven (7) calendar days to the Head of HR. The appeal will be reviewed in line with the Company's grievance and disciplinary policy.

Acknowledgement

Signed
Date

Document Control

FieldValue
Document OwnerHuman Resources — {{company_name}}
CategoryTermination
Version1.0
Effective Date{{date}}
Next ReviewAnnually from effective date
Approved By{{manager_name}}
ClassificationInternal — Confidential

Related templates