exit interview form template

Exit Interview Form

What is the purpose of an exit interview? This sample form template is ready-made and easy to customize in a word processor, such as MS Word or Google Docs, etc.

bizzlibrary template file type image
.docx (0.02 MB)


In an organization, its common people come and go. If they have shown their intention to leave, it's important that the organization fully understands the reasons for leaving, and it's common to hold an exit interview.

What is the purpose of an exit interview?

The exit interview is your final chance to share your thoughts and feelings about your workplace, boss, and company policies. It's also an opportunity for you to provide honest feedback about what you do like and don't like about the job. This feedback can be invaluable in helping improve the work environment for future employees. The main purpose of an exit interview is to collect feedback from employees about where the company needs to improve. It's also an opportunity to make sure that departing employees feel positive about their time with the company, and in some cases, it may even convince them to stay on under new circumstances. An exit interview is a meeting between an employee who is leaving the company and (usually) a member of the human resources department. Exit interviews provide you with the opportunity to learn more about why an employee leaves, which can provide you with important feedback that you can use to improve the workplace for your team members and future employees.
Exit Interview Form

Directions: This form is to be completed by the employee and the employee’s supervisor. A copy should be made and retained by the supervising administrator. After concluding the exit interview with his supervisor, the employee should schedule an appointment with the benefits specialist in HR and bring the exit interview form with him when he attends the appointment. The benefits specialist will complete the exit interview process. All final paychecks will be mailed after the employees last day worked and the exit interview has been completed. Checks will run according to the normal payroll schedule. If the employee fails to schedule and attend the appointment in HR, his final check will not be direct deposited. He will need to pick up his check when he completes the exit interview process.
  • Name
  • Signature of HR personnel
  • Signature of Employee
  • Signature of Administrator
  • I have been advised Human Resources is not aware of all items needing to be turned in. HISD will hold my final paycheck until verified with campus administrator that all items have been returned. initial
  • Comments
  • Benefits
    • Books
    • Equipment
    • Keys
    • District property
    • Door badge and ID
  • Checkout Procedures:
  • Where applicable, review and discuss the following items:
  • Phone Number E-mail (non ISD) Forwarding Address From To Campus/Dept Dates Worked to
  • Phone Number
  • E-mail (non ISD)
  • Forwarding Address
  • Campus/Dept. Dates Worked to
  • E-mail (non ISD)
  • Forwarding Address
  • Campus/Dept. Dates Worked to
  • Job Title

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Lorretta Esparza(10/10/2022) - AUS

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