exit interview sample sheet template

Exit Interview Sample Sheet

How do you fill up the exit interview sheet? Just download this printable interview template and use it as a guide for writing your own personalized sheet.

bizzlibrary template file type image
.docx (0.01 MB)


An exit interview is a meeting between an employee who is leaving the company and 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.

How do you fill-up the exit interview sheet?

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.

  • Name of Employee:
  • Date of exit interview:
  • Employee Supervisor:
  • Please be advised that (Name) , Employee # , has terminated employment with the {{Company’s Name}} for the following reasons(s);
    • Quit, reason unknown
    • Quit, starting employment elsewhere
    • Discharged for Misconduct
    • Failed to meet performance standards
    • Lack of Work
    • Employee is retiring
    • Other:
  • Do you expect to recall this employee?
  • Employee is no longer considered an employee of the Town of Berlin for any reason (not eligible to return at all).
  • Employee is no longer a permanent employee but may return from time to time as part-time employee in my department.
  • Employee is no longer employed in our department, but remains working as a town employee in the following capacity:
    • On-Call Patrolman or Dispatcher
    • Law Enforcement – Details/Special Duty
    • Election Worker
    • Highway – On-call snow plowing/tree removal/storm damage
    • Call Firefighter
    • EMT/First Responder
    • Substitute Teacher
    • Other     
  • Effective Date of Termination/Retirement:
  • Has employee been advised of COBRA rights if applicable?
  • Items to be returned (where applicable): employee to date and initial:
    • Keys
    • Computer Equipment
    • Blackberry
    • Town Phone
    • Other items:    

What is an exit interview for example?

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.

Download this exit interview sheet for free from our website. Make some changes to the document available in Microsoft Word format. If you like this letter, please give us a big thumbs up. Your valuable feedback matters a lot to us—Head towards our website for some useful content.

The content is for informational purposes only, you should not construe any such information or other material as legal, tax, investment, financial, or other advice. Nothing contained this site constitutes a solicitation, recommendation, endorsement, or offer by Bizzlibrary or any third party service provider to buy or sell any securities or other financial instruments in this or in any other jurisdiction in which such solicitation or offer would be unlawful under the securities laws of such jurisdiction.


Ivana Bullock(9/16/2022) - AUS

Thank you for this!!

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