Dillingham Consulting

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📋 Exit Interview Questionnaire

Confidential interview conducted at separation. Responses are used to improve our workplace and are stored securely.

Departing employee

Separation Details

Last day of employment *

Reason for leaving *

New employer (if applicable)

New role / industry (if applicable)

Would you consider returning to work here in the future?

Yes No Maybe

Job Satisfaction

Overall, how satisfied were you with your role?

1 = Very dissatisfied 5 = Very satisfied

Satisfaction

How would you rate the following?

1 = Poor 5 = Excellent

Work-life balance

Compensation

Benefits

Career growth

Training & support

What did you enjoy most about your role?

What could have been improved about your role?

Management & Team

How would you rate your relationship with your supervisor?

Relationship

Did you feel supported by management?

Yes, consistently Sometimes Rarely No

What feedback would you offer to management?

How would you describe the team culture?

Work Environment

Did you feel you had the tools and resources to do your job effectively?

Yes Mostly Somewhat No

Did you ever experience or witness workplace harassment or discrimination?

No Yes — reported Yes — not reported Prefer not to say

If yes, please describe (optional)

What changes would most improve the workplace for future employees?

Career Development

Did you feel there were adequate opportunities for career growth here?

Yes Somewhat No

Were your skills and experience fully utilized in your role?

Yes Partially No

What training or development opportunities would have helped you succeed?

Final Thoughts

Would you recommend this organization as a place to work?

Definitely yes Probably yes Not sure Probably not Definitely not

What is the primary reason you are leaving? (in your own words)

What would have caused you to stay?

Any additional comments or suggestions?

HR Notes (Internal — not shared with employee)

Interview conducted by

Interview date

HR internal notes

Eligible for rehire?

Yes No Conditional

🔒 Responses are saved confidentially and used for HR reporting only.

✅

Exit Interview Saved

The interview has been saved to the employee's offboarding record.

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