Exit Interview Pulse Survey Template
Title Exit Interview Survey
Welcome Message We appreciate the work you’ve done with us, and we’re sorry to see you go! Please help us understand more about your decision to leave COMPANY.
Linear Scale Question 1 How would you rate the culture at COMPANY?
1 - Unhealthy
2
3
4
5 - Healthy
Long Answer Text Box 1 How would you describe COMPANY's culture?
Linear Scale Question 2 How would you rate the work-life balance at COMPANY?
1 - Unhealthy
2
3
4
5 - Healthy
Linear Scale Question 3 I had the opportunity to utilize my skills and abilities.
1 - Not at all true
2
3
4
5 - Very True
Linear Scale Question 4 I had the opportunity to grow and develop my career.
1 - Not at all true
2
3
4
5 - Very True
Linear Scale Question 5 I felt supported during the onboarding process.
1 - Not at all true
2
3
4
5 - Very True
Long Answer Text Box 2 How can we improve onboarding, training, and development?
Short Answer Text Box 1 How long were you in this role?
Linear Scale Question 6 My role and responsibilities matched my expectations.
1 - Not at all true
2
3
4
5 - Very True
Long Answer Text Box 3 Did your role change after you were hired? If so, how?
Linear Scale Question 7 The workload for my role was reasonable.
1 - Not at all true
2
3
4
5 - Very True
Linear Scale Question 8 I felt my compensation matched up with my role and responsibilities.
1 - Not at all true
2
3
4
5 - Very True
Linear Scale Question 9 I felt my compensation and benefits package were competitive to other organizations.
1 - Not at all true
2
3
4
5 - Very True
Linear Scale Question 10 I was satisfied with my benefits package.
1 - Not at all true
2
3
4
5 - Very True
Long Answer Text Box 4 Which benefits did you take advantage of?
Linear Scale Question 11 I felt challenged by my role.
1 - Not at all true
2
3
4
5 - Very True
Linear Scale Question 12 I felt supported by my supervisor.
1 - Not at all true
2
3
4
5 - Very True
Linear Scale Question 13 Please rate your overall relationship with your supervisor.
1 - Poor
2
3
4
5 - Excellent
Long Answer Text Box 5 Anything else you'd like to share about your supervisor?
Linear Scale Question 14 Please rate your overall relationship with your team.
1 - Poor
2
3
4
5 - Excellent
Linear Scale Question 15 Please rate the culture of your team overall.
1 - Poor
2
3
4
5 - Excellent
Long Answer Text Box 6 Anything else you'd like to share about your team environment?
Long Answer Text Box 7 What is your main reason for leaving COMPANY?
Long Answer Text Box 8 Why did you initially begin looking for a new position?
Long Answer Text Box 9 Was there a person or event that sparked looking for a new position?
Long Answer Text Box 10 Is there anything we could have done to have you continue in your role?
Linear Scale Question 16 How likely are you to return to this role in the future?
1 - Very Unlikely
2
3
4
5 - Very Likely
Linear Scale Question 17 How likely are you to recommend others to work at COMPANY?
1 - Very Unlikely
2
3
4
5 - Very Likely
Long Answer Text Box 11 What would you change about COMPANY?
Long Answer Text Box 12 What do you feel COMPANY does well?
Long Answer Text Box 13 Anything else you'd like to share or would like leadership to know?
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