HTML Preview Staff Exit Interview Form page number 1.
Jeesal Learning Disability Services
Staff Exit Interview Form Version: 02 (11/2013)
Page 1 of 2
STAFF EXIT INTERVIEW FORM
It is both regrettable and potentially expensive when an employee decides to leave the
Company. It is therefore essential that we find out the reason why, if we are going to avoid
losing good people in the future. Once an individual decides to leave, they are likely to give
a frank and honest input which is invaluable to the Company in identifying why people leave
and giving ideas which can be implemented to change the Company for the better. We
would therefore ask you to complete the following questionnaire and return it promptly to
your manager who will forward a copy to the HR Department.
With your permission, the information gained from this completed questionnaire will be
discussed with the management of the Company. The aim of this is to ensure that any
problem issues can be discussed and resolved before you leave. It also means that if we
discover you are leaving as a direct result of perceived problems of which we were
previously unaware, the Company can try to resolve these to the mutual satisfaction of all
parties before you leave. A copy of this questionnaire will be retained by HR Department
and also be placed on your personnel file.
Name
Job Title
Home / Location/
Department
Positive aspects of
employee’s time at
the Jeesal Group as
stated by Employee
Negative aspects of
employee’s time at
the Jeesal Group as
stated by Employee
Things that could
be improved as
stated by the
Employee
Date of joining
Date of leaving
Reason for leaving
given by the
Employee/ Any
other comments
from Employee