Exit Interview Form: Everything You Should Include (And A Sample)

May 01, 2018 by Aley Brown

Are you looking to let go of some employees? If you are, it is imperative that your organization conduct exit interviews, and thus have exit interview forms available.

Exit Interview Form

Exit interviews are a vital part of the talent management process that usually goes overlooked. Many HR teams are so busy with their normal people management duties, that when employees are let go, conducting an exit interview is an afterthought.

Before we dig into what should be included on your exit interview forms, make sure to download our sample form with the button below:

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If done properly, exit interviews can be a great tool for understanding the dynamics in your workforce and taking stock of the success of your talent management initiatives.

For example, let’s say that your company recently started a diversity and inclusion initiative. During your exit interviews, you could include a question about how this program impacted your employee, and then use that to gauge the success of your initiative.

I know what you’re thinking: will employees actually be honest during exit interviews?

Well, for the most part, yes. You will get some employees who are overly positive about their employee experience, because they don’t want to burn any bridges that could help them in the future. You will also get some employees that are overly negative about their experience (especially if they have been laid off or fired).

Exit Interview Form

But, the majority of your employees will be honest and realistic about their experience. Most will be even more honest than usual (but not to the point of ruining their reputation), but more than they would be if they were still employed. This is because they don’t fear the short term repercussions of being honest about any workforce issues that caused them problems in their role.

And this is why your organization should always conduct exit interviews, regardless of the condition of the loss of employment (voluntary, laid off, fired, etc).

Now let’s get started!

What To Include In Your Exit Interview Form

Your exit interview form should have two parts. The first part should consist of sections that aim to gather information about the employee, and what their plans are for the future.

The second part will focus more on sections that will allow your employee to provide feedback about their employee experience.

The first thing that needs to be included in your exit interview form are fields that hold basic employee information. This information will help you organize your forms into different categories for data analysis, and will be helpful if there are any follow up tasks directly resulting from the exit interview.

Here are the fields that are normally included:

  • Date
  • Name
  • SSN
  • Department
  • Supervisor
  • Hire Date
  • End Date
  • Starting Position
  • Ending Position
  • Starting Salary
  • Ending Salary

The next section of the form should include why your employee is now exiting the organization. It makes sense to have different categories in this section, and then different reasons in each category that are more specific. Category examples could be a layoff, termination, voluntary separation, or retirement.

Exit Interview Form

And underneath these categories the different reasons could have specific details such as: “lack of work” or “dissatisfaction with salary”.

Here are some examples of details for each specific category:


  • Took Another Job
  • Family Needs
  • Poor Health
  • Relocation To Another City
  • Travel Difficulties (commuting)
  • Going Back To School
  • Dissatisfied With Salary
  • Dissatisfied With Type Of Work
  • Dissatisfied With Supervisor
  • Dissatisfied With Coworkers
  • Dissatisfied With Working Conditions
  • Dissatisfied With Benefits

Laid Off:

  • Lack Of Work
  • Lack Of Funds
  • Position Elimination


  • Voluntary Retirement
  • Regular Retirement
  • Disability Retirement

It is also a good idea to include an “other” option with a text box for employees to further explain why they are leaving your organization.

Exit Interview Form

Next, leave a paragraph’s worth of space on the form for a field that asks your exiting employee to explain their plans after leaving the organization. This could include where they plan to work, where they are at with their job search process, if they are planning on not working, etc.

After this section of part 1, you should be ready to create the 2nd section where you will ask more detailed questions about the employee’s experience at your organization.

This section should have both open ended questions about their experience, and ranking questions. The ranking questions will allow you to run data analysis that could be meaningful to your talent management initiatives, while the open ended questions could provide helpful anecdotes that your HR team wouldn’t get from looking at raw data.

Common open ended questions that are used on an exit interview form are:

  • What did you like most about your job?
  • What did you like least about your job?
  • If you are taking another job, what kind of work will you be doing?
  • What has your new place of employment offered you that is more attractive than your present job?
  • Could [company name] have made any improvements that might have influenced you to stay at the job?

Provide a few lines of space underneath each question to allows your employees to provide information.

Exit Interview Form

Ranking questions should be simple to understand, and have predetermined answers that range from dissatisfied to satisfied. Most organizations use a scale for their answers like this:

A= Very Satisfied
B= Satisfied
C= Neutral
D= Dissatisfied
E= Very Dissatisfied

Common ranking questions usually focus on benefits and pay:

  • Rate of pay for your job
  • Paid holidays
  • Paid vacations
  • Retirement plan
  • Medical coverage for self
  • Medical coverage for dependents
  • Life insurance
  • Sick leave

Or the overall employee experience working in this particular job:

  • Opportunity to use your abilities
  • Recognition for the work you did
  • Training you received
  • Your supervisor’s management methods
  • The opportunity to talk with your supervisor
  • The information you received on policies, programs, projects and problems
  • The information you received on departmental structure
  • Promotion policies and practices
  • Discipline policies and practices
  • Job transfer policies and practices
  • Overtime policies and practices
  • Performance review policies and practices
  • Physical working conditions

So, each of these factors would receive a ranking from your exiting employee on a scale that ranges from very satisfied to very dissatisfied. This provide multiple data points and can help your HR team get a really clear picture of talent manage strengths and weaknesses.

It is also a great idea to add a section below this ranking section where exiting employees can leave any further comments about the rankings they provided above.

Exit Interview Form

Finally, at the bottom of the form create one final area where these employees can once again leave any final comments about their experience. After that section, create an employee signature and date field, along with an interviewer signature and date field.

As soon as possible your interviewer (who should be an unbiased HR rep), should enter the data from the interview into your HR database. It is best practice to then run a report in a regular cadence for your executives that highlight any strengths or weaknesses of your talent management processes.

Any immediate concerns that result after an exit interview, such as allegations of discrimination, illegal activities, etc., should be reported immediately to the head of HR at your organization. The head of HR should then develop a plan to address these pressing concerns as quickly as possible.

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Aley Brown

Aley Brown

Aley is a versatile global business leader with proven experience managing high-performing teams and engaging a data-driven approach to strategies that exceed company objectives.

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