Exit interview (comprehensive)				 		Form 15

We would like to thank you for your loyalty, hard work and dedication that you displayed as a member of our team. Although your departure is a loss to our business, we wish you the very best in your future career choices.

As a departing member of our team, we value any comments or feedback you are willing to share with us regarding the strengths of our business and any areas where we could improve as an employer and provide a better place to work.

Your comments and suggestions can assist us to improve the way we operate and the working environment.

You can complete the exit interview form yourself or participate in an interview with a nominated manager.

Your details 	
Current age	Employment status	Length of service	
	15–25 years		Permanent full-time		0–6 months	
	26–35 years		Permanent part-time		6–12 months	
	36–45 years		Contract full-time		1–2 years	
	45–55 years		Contract part-time		2–5 years	
	> 55 years		Casual		5–10 years	
			Temporary		> 10 years	
			Other:_________________			
Gender	Position title		
	Male	
	Female	
Name (optional):		Manager’s name (optional):		

Reason for leaving	
	Self-employment		Maternity/family reasons		Retirement		Salary	
	Job dissatisfaction		Interpersonal conflict		Travel		Study	
Other:	

About us	
What are the things you believe this business does well?	

What do you consider to be some of the highlights or positive experiences of your employment?	

If you are leaving to join another organisation, what does it offer that we do not?	

Could we have done something differently to encourage you to stay?	

Exit interview (comprehensive) (cont.)					Form 15
About us	
What are the things you believe we need to improve on?	

What do you consider to be some of the unhappy or negative experiences of your employment?	

How well do we deal with career development? 	

Would you recommend employment with us to a friend? Why/why not?	

About us   Please select from: 1 – Highly Satisfied 2 – Satisfied 3 – Neutral 4 – Dissatisfied 5 – Highly Dissatisfied	
	1		2		3		4		5	Workload and task allocation was appropriate	
	1		2		3		4		5	Ability to obtain leave	
	1		2		3		4		5	Work safety	
	1		2		3		4		5	Facilities	
	1		2		3		4		5	Management dealing with conflict	
	1		2		3		4		5	Induction or orientation process (on commencement)	
	1		2		3		4		5	Job satisfaction with your role	
	1		2		3		4		5	Job security	
	1		2		3		4		5	Performance management process (feedback on your performance)	
	1		2		3		4		5	The opportunity to use your existing skills/knowledge	
	1		2		3		4		5	Availability of work-related training/education/professional development	
	1		2		3		4		5	Employee involvement in improving standards and conditions	
	1		2		3		4		5	Work performance/efforts recognised	
	1		2		3		4		5	Work area adequately equipped	
	1		2		3		4		5	Flexible working hours	
	1		2		3		4		5	Communication of decisions and other issues affecting you	
	1		2		3		4		5	Relationship with your immediate manager	
	1		2		3		4		5	Team environment (approachability and relationships with peers)	

Please provide any other information not covered above that has influenced your decision to cease your employment with us.	

	

Thank you for your time and honesty.