Surveyonics - Online Survey Software

Obtaining Feedback from Departing Employee
For your convenience and ease of reference, we have created a template of Employee Exit Survey. You can use this template as such or modify it to suit your needs. Alternatively, you can design your own survey from scratch.

 Question: Please rate the following aspects of the job you held with us.
Very goodGoodAveragePoorVery poor
Remuneration
Employee benefits
Rewards and recognition
Career advancement
Job challenge
Communication
Job autonomy
Physical conditions of work
Workload
Training
 Question: For what reason(s) are you leaving the company? (Choose all that apply.)
Remuneration
Employee benefits
Career advancement
Career change
Conflict with supervisor
Conflict with management
Conflict with co-workers
Working conditions (physical conditions of work, working hours, workload, etc.)
Nature of work
Job security and stability
Personal reasons
Relocation
Higher education

Other, please specify.
 Question: Please select the option that best describes the following statements about the management.
Strongly agreeAgreeNeither agree nor disagreeDisagreeStrongly disagree
The management was friendly and open
minded.
The management was fair and impartial.
The management was considerate and understanding.
The management was able to effectively handle all kinds of issues arising in the workplace.
 Question: Did you ever have any kind of grievance during the course of your employment with our company?
Yes
No

If yes, was the grievance resolved?
 Question: Would you ever consider working with us again?
Yes, why not.
I don't think so.
Can't say.
 Question: The grievance handling procedure was:
Highly effective
Effective
Somewhat effective
Ineffective
Not applicable
 Question: If you have any suggestions regarding changes/improvements that can be made in the company, please write them in the space below.
 Question: What kind of organization is your new place of work?
Commercial
Governmental
Non-governmental
Not applicable
 Question: What was your motivation for joining our company? (Choose all that apply.)
Needed work
Remuneration
Employee benefits
Career advancement
Company's reputation
Company's mission

Other
 Question: Please select the option that best describes the following statements about your immediate supervisor.
Strongly agreeAgreeNeither agree nor disagreeDisagreeStrongly disagree
My supervisor and I had a good working relationship.
My supervisor gave clear and precise instructions.
My supervisor was open to suggestions and new ideas.
My supervisor had a good knowledge of the job.
My supervisor never failed to recognize employees' contribution.
 Question: If you had a similar opportunity in our company, would you have stayed?
Yes
No
Can't say
 Question: Do you think you could have a similar opportunity in our company?
Yes
No
Can't say
 Question: Please specify your gender.
Male
Female
 Question: For how long did you work in our company?
Less than six months
Less than a year
Less than two years
Less than 5 years
Less than 10 years
 Question: Please give a brief description of the kind of work and responsibilities you will be handling in your new place of work. (Optional)
 Question: What department were you working in?
Administration
Customer Service
Finance
Human Resources
Information Technology
Marketing
Sales

Other