Sample Employee Exit Survey for USA based HR Personnel
USA Employee Exit Survey has a list of free online sample staff exit interview questions. You may use this as a template to create your own Employee exit survey by adding more questions to this list of exit interview survey questions.

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 USA Employee Exit Survey
Why USA Employee is leaving..

We are sad that you will no longer be working with our company. We would like to know about your experience of working with us and the reasons why your quitting. Please take a few minutes to complete this survey. We would really appreciate it if you make your responses as candid and honest as possible.

1.  If you had a similar opportunity in our company, would you have stayed?

  Can't say

2.  Did you ever have any kind of grievance during the course of your employment with our company?


3.  Please select the option that best describes the following statements about your immediate supervisor.

Strongly agreeAgreeNeither agree nor disagreeDisagreeStrongly disagree
My supervisor and I had a good working relationship.
My supervisor gave clear and precise instructions.
My supervisor was open to suggestions and new ideas.
My supervisor had a good knowledge of the job.
My supervisor never failed to recognize employees' contribution.

4.  Please select the option that best describes the following statements about the management.

Strongly agreeAgreeNeither agree nor disagreeDisagreeStrongly disagree
The management was friendly and open
The management was fair and impartial.
The management was considerate and understanding.
The management was able to effectively handle all kinds of issues arising in the workplace.

5.  What kind of organization is your new place of work?

  Not applicable

6.  What was your motivation for joining our company? (Choose all that apply.)

  Needed work
  Employee benefits
  Career advancement
  Company's reputation
  Company's mission

7.  What department were you working in?

  Customer Service
  Human Resources
  Information Technology

8.  Please give a brief description of the kind of work and responsibilities you will be handling in your new place of work. (Optional)

9.  Please specify your gender.


10.  Please rate the following aspects of the job you held with us.

Very goodGoodAveragePoorVery poor
Employee benefits
Rewards and recognition
Career advancement
Job challenge
Job autonomy
Physical conditions of work

11.  For how long did you work in our company?

  Less than six months
  Less than a year
  Less than two years
  Less than 5 years
  Less than 10 years

12.  For what reason(s) are you leaving the company? (Choose all that apply.)

  Employee benefits
  Career advancement
  Career change
  Conflict with supervisor
  Conflict with management
  Conflict with co-workers
  Working conditions (physical conditions of work, working hours, workload, etc.)
  Nature of work
  Job security and stability
  Personal reasons
  Higher education

13.  The grievance handling procedure was:

  Highly effective
  Somewhat effective
  Not applicable

14.  Do you think you could have a similar opportunity in our company?

  Can't say

15.  If you have any suggestions regarding changes/improvements that can be made in the company, please write them in the space below.

16.  Would you ever consider working with us again?

  Yes, why not.
  I don't think so.
  Can't say.