Exit Survey Form

Department (optional)

Rank these factors by their influence on your decision*

1.New Job

2.Compensation

3.Work Environment

4.Management

5.Lack of Growth

6.Personal

Rate your experience*

	Poor	Fair	Good	Very Good	Excellent
Overall Experience
Team & Culture
Compensation & Benefits
Career Development Opportunities

What is one thing we should change?

Would you recommend this company to others?*

What is this form?

An exit survey form for collecting anonymous feedback from departing employees or members. Shorter and more survey-focused than a full exit interview.

Who is it for?

HR departments and organizations that want to collect exit feedback at scale, especially when a full interview isn't feasible.