"Exit Interview Questionnaire Form - Coastal Connections, Inc."

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Coastal Connections, Inc.
Exit Interview Questionnaire
Employee Name
Hire Date
Department
Termination Date
Position
Please briefly describe the circumstances for your separation from Company Name:
How would you rate the following aspects of your job?
Needs
Adequate
Inadequate
Improvement
Supervision Received
Development Opportunities
Working Conditions
Workload
Pay
Benefits
Other
Would you please specify:
If you are going to a new employer, what does the new job offer that your job with us did not?
Additional comments about your job, department, or our company.
Coastal Connections, Inc.
Exit Interview Questionnaire
Employee Name
Hire Date
Department
Termination Date
Position
Please briefly describe the circumstances for your separation from Company Name:
How would you rate the following aspects of your job?
Needs
Adequate
Inadequate
Improvement
Supervision Received
Development Opportunities
Working Conditions
Workload
Pay
Benefits
Other
Would you please specify:
If you are going to a new employer, what does the new job offer that your job with us did not?
Additional comments about your job, department, or our company.