Termination Exit Interview and Checklist
Employee Name: _______________________________________________ Date: ____/_____/_____
Department: ___________________________________Position: _____________________________
Supervisor:________________________________________ Emp. Dates: ___/___/___ to ___/___/___
Employee has been informed of the following:
Solicitations of customers (if applicable)
Removing company documents
Confidentiality obligations (if applicable)
Restrictions on solicitations of employees (if applicable)
Customer lists
Other: ____________________________________________________________
The employee has returned the following:
Keys
Company equipment (computer, cell phone. Etc)
Laptop
Cell phone
Other: ____________________________________________________________
Company credit card N/A
Company documents
ID card
Uniform N/A
We would appreciate it if you would take a few minutes to respond to the following questions. All answers will be held in strict confidence.
Why are you leaving the company
________________________________________________________________________________
________________________________________________________________________________
Would you consider coming back to work here? Why or why not?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Do you feel you were compensated fairly for the work you did?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Do you feel that management recognized your accomplishments?
________________________________________________________________________________
________________________________________________________________________________
Do you feel you were given adequate training?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Did you have the necessary technology tools and equipment to perform your position?
Yes No (if no – what could be improved?
________________________________________________________________________________
________________________________________________________________________________
Were you content with your working conditions? If not, what could have been improved?
________________________________________________________________________________
________________________________________________________________________________
How could the company be a better place to work?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Interviewer’s signature: _____________________________________________Date: ___/_____/____