Employee Exit Interview Form

Why are employees leaving your company? Use this form to help guide an exit interview and learn what your organization can do better.

This template includes a Net Promoter Score question to help gauge how well your brand is performing with departing employees. Questions in this form also include items that cover how well an employee was treated, if the employee had the tools to do their job, and the employees rating of their compensation package.

After an employee completes this form, generally a supervisor will sit with the employee to go over any further details. The feedback gathered here can be aggerated and shared with additional supervisors and even benchmarked. Establishing good data benchmarks will help improve employee retention rates.

A successful employee exit interview survey should be simple. The employee is leaving so don't overwhelm them with a long or complex survey that they likely won’t complete.

Number of questions: 19
Number of Pages: 1

Use this template

How to Send the Survey

  • The easiest method would be using our email collector. This will streamline the process for you. You can add custom attributes to your invitations, so results can be segmented by department, location, etc.
  • A simple weblink could be used to quickly send this out from your own email account.
  • A text message collector would also work good here. You can simply text the employee on one of their last days working for you. The employee would quickly give feedback, and a manger can go over results with the individual before parting ways with the employee.
  • Transactional collectors would also allow you to send the invitation from your own email account, and give you the ability to add custom attributes to then be able to segment the results.

Working With Your Data & Tips

The results from your first few exit interviews will establish your benchmark data.

With your data, you can create reports to share. The data can be reviewed with the HR team and shared with additional management.

Take the feedback to heart. A departing employee filled out this form with intentions that their feedback would be valued and acted upon. The cost of a lost employee can range from 1.5 - 2.0 times the employees annual salary.


Using data gathered from this employee exit interview form will help you build a better organization and reduce costs in the long term!