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Exit Interview Form

Exit Interview Form

EXIT INTERVIEW FORM

Employee Name: [Employee Name]

Job Title: [Job Title] Department: [Department]

Hire Date: [Hire Date] Last Day: [Last Day]

Separation Type: [Separation Type]

Interview Date: [Interview Date] Interviewer: [Interviewer]

This exit interview is conducted to gather feedback from departing employees to improve the workplace. Participation is voluntary. Responses will be kept confidential to the extent permitted by law and will be used for HR analysis and organizational improvement.

SECTION 1 — REASON FOR LEAVING

Primary Reason for Departure:

[Primary Reason]

Additional Details:

[Primary Reason Detail]

SECTION 2 — ROLE AND JOB SATISFACTION

Job Responsibilities Clarity: [Role Clarity]

Resources and Tools Adequacy: [Resources Adequate]

What the Employee Most Enjoyed:

[Satisfaction Feedback]

SECTION 3 — MANAGEMENT AND LEADERSHIP

Direct Manager Rating: [Management Rating]

Management Comments:

[Management Comments]

SECTION 4 — CULTURE, COMPENSATION, AND RETENTION

Company Culture:

[Culture Comments]

Compensation Fairness: [Compensation Fairness]

What Could Have Retained This Employee:

[Retention Factors]

Would Recommend as Employer: [Would Recommend]

SECTION 5 — ADDITIONAL COMMENTS

[Additional Comments]

ACKNOWLEDGMENT

By signing below, the employee acknowledges voluntary participation in this exit interview and that their responses have been accurately recorded.

Employee Signature: _______________________________ Date: _______________

Printed Name: [Employee Name]

HR Interviewer Signature: _______________________________ Date: _______________

Printed Name: [Interviewer]

FOR HR USE ONLY — Action Items / Escalation Notes:

_______________________________________________________________________________

_______________________________________________________________________________

Departing Employee

________________

Signature

HR Interviewer

________________

Signature

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a Exit Interview Form?

An Exit Interview Form in the United States captures the structured information needed to complete the process it supports.

Exit interviews serve three primary organizational functions. The first is retention intelligence: systematically analyzing why employees leave reveals patterns — inadequate pay, poor management, lack of career advancement, inflexible work arrangements, hostile culture — that, when addressed, reduce voluntary turnover. The Society for Human Resource Management (SHRM) estimates the total cost of replacing an employee at 50% to 200% of their annual salary, covering recruitment advertising, recruiter fees, hiring manager time, onboarding costs, and productivity loss during the learning curve. Exit interview data, when aggregated across departments and tenure bands, provides the factual basis for evidence-based retention investments.

The second function is legal risk identification. When a departing employee discloses during an exit interview that they experienced or witnessed workplace harassment, discrimination, retaliation, wage theft, safety violations, financial fraud, or other legally actionable conduct, the employer receives notice of the potential claim. This notice triggers the employer's obligation to investigate under the Faragher-Ellerth affirmative defense framework established by the Supreme Court in Faragher v. City of Boca Raton, 524 U.S. 775 (1998), and Burlington Industries, Inc. v. Ellerth, 524 U.S. 742 (1998): employers can avoid vicarious liability for supervisor harassment only if they took reasonable care to prevent and promptly correct harassing behavior, and the employee unreasonably failed to use the employer's complaint procedures. An exit interview disclosure that is not investigated eliminates this defense.

The third function is knowledge transfer. For technical, managerial, and client-facing roles, exit interviews document institutional knowledge — active client relationships, pending projects, process documentation gaps, system passwords and access credentials, key vendor contacts — that would otherwise leave with the departing employee and create operational disruption. Knowledge transfer checklists integrated into the exit interview form reduce the business continuity risk of key employee departures.

When Do You Need a Exit Interview Form?

An Exit Interview Form is needed whenever a full-time or part-time employee voluntarily resigns, is laid off, retires, or has their employment terminated, and the employer wishes to gather structured feedback about the employee's experience.

Voluntary resignations represent the highest-value use case for exit interviews because departing employees choosing to leave typically have the most candid perspective on what drove their decision — and that information is most actionable for retention. SHRM data indicates that exit interview programs reduce voluntary turnover by an average of 10% to 15% when findings are systematically acted upon.

Layoffs and reduction-in-force (RIF) events benefit from structured exit processes that serve a dual purpose: collecting operational knowledge transfer information from departing employees, and creating a documented record of the separation process that protects the employer from claims that specific employees were selected for layoff on discriminatory grounds. Exit interview records from a RIF, combined with objective selection criteria documentation, support the employer's defense in ADEA disparate impact claims under 29 U.S.C. § 623(a)(1).

Key employee departures — executives, senior engineers, client relationship managers, and others whose roles involve significant institutional knowledge, client relationships, or access to trade secrets — require structured exit interviews that include both feedback collection and a formal knowledge transfer checklist. For departing employees who hold confidential information or trade secrets, the exit interview should include a review of post-employment obligations under any executed non-disclosure agreement (NDA), Defend Trade Secrets Act (DTSA) provisions (18 U.S.C. § 1836), and applicable state trade secret statutes.

High-turnover departments or roles benefit from quarterly or semi-annual aggregated exit interview analysis to identify systemic management or culture issues before they compound. If a particular manager's team experiences consistently higher voluntary turnover than comparable teams, exit interview data provides the objective basis for management coaching or corrective action.

Retirement exits, particularly from long-tenured employees with specialized expertise, require exit interviews focused on succession planning, institutional knowledge documentation, mentoring arrangements for successors, and any consulting arrangements under which the retiree may continue to provide services.

What to Include in Your Exit Interview Form

A structured Exit Interview Form must address multiple dimensions of the employee's experience while creating a legally defensible record and operationally actionable data.

Employee and separation information: The form must identify the departing employee by name, employee ID, department, job title, manager, hire date, last day of employment, and type of separation (voluntary resignation, involuntary termination, layoff, retirement). This information is required for EEO-1 reporting purposes, state unemployment insurance administration, and COBRA continuation coverage notification under 29 U.S.C. § 1161 et seq., which requires employers to provide COBRA election notices within 14 days of a qualifying event.

Reason for leaving: The form must ask the departing employee to identify their primary reason for leaving from a standardized list of categories — better compensation elsewhere, better career advancement opportunity, dissatisfaction with management, dissatisfaction with company culture, personal/family reasons, relocation, retirement, health reasons, returning to school — supplemented by open-ended explanation fields. Standardized categories enable quantitative analysis across a population of exit interviews; open-ended fields capture nuance. The form should also ask whether the employee would consider returning to the company in the future.

Workplace experience assessment: The form should ask the employee to rate their experience across key dimensions on a numeric scale (1-5 or 1-10): overall job satisfaction; satisfaction with compensation and benefits; quality of management and supervision; opportunities for professional development and career advancement; clarity of job expectations; quality of communication from leadership; work-life balance and schedule flexibility; and physical and psychological safety in the workplace.

Management and HR practices: The form should ask specific questions about the employee's direct manager — whether the manager provided regular feedback, recognized accomplishments, treated the employee fairly, and supported professional growth. This information is the most actionable for targeted management development interventions.

Legal disclosure section: The form must include a clearly stated question asking whether the employee experienced or witnessed any conduct they believed to be harassment, discrimination, retaliation, wage and hour violations, workplace safety violations, or other unlawful conduct during their employment. This question is essential for invoking the employer's post-notice investigation obligation under Faragher-Ellerth and applicable state anti-discrimination laws including the California Fair Employment and Housing Act (FEHA), Gov. Code § 12940, and the New York State Human Rights Law, Exec. Law § 296. The form should also include a question about whether the employee reported any such conduct during employment and, if so, whether the response was satisfactory.

Knowledge transfer section: For key roles, the form should include a structured knowledge transfer checklist covering: active client relationships and pending commitments; ongoing projects and their status; access credentials and system logins to be transferred; key internal and external contacts; process documentation that the employee should create or update before their last day; and unfinished tasks requiring handoff.

Voluntariness and confidentiality statement: The form must state that completion is voluntary, that responses will be kept confidential to the extent practicable (with the caveat that legally significant disclosures require investigation), and that the information will be used to improve the workplace. Exit interview records should be retained as part of employment records for the minimum period required under applicable state law — typically 3 years after separation under EEOC recordkeeping regulations at 29 C.F.R. § 1602.14.

Sources & Citations

Statutory citations link to official government sources.

  1. 524 U.S. 775 (1998)US – Justia
  2. 524 U.S. 742 (1998)US – Justia
  3. 29 U.S.C. § 623US – Cornell LII
  4. 18 U.S.C. § 1836US – Cornell LII
  5. 29 U.S.C. § 1161US – Cornell LII
  6. Defend Trade Secrets ActUS – Cornell LII
  7. DTSAUS – Cornell LII
  8. 29 C.F.R. § 1602.14US – eCFR
  9. ADEAUS – Cornell LII

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Exit Interview Form (United States) [Legal document template]. Forms Legal. https://forms-legal.com/usa/employment/termination/exit-interview-form

MLA

"Exit Interview Form (United States)." Forms Legal, 2026, https://forms-legal.com/usa/employment/termination/exit-interview-form.

BibTeX
@misc{formslegal-exit-interview-form,
  author       = {{Forms Legal}},
  title        = {Exit Interview Form (United States)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/usa/employment/termination/exit-interview-form}},
  note         = {Free legal document template. Based on Fair Labor Standards Act (29 U.S.C. §201-219)}
}

Frequently Asked Questions

Based on Fair Labor Standards Act (29 U.S.C. §201-219) — Template last modified June 2026Verify the source →

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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