Employee details
Name: ____________ Role and team: ____________ Manager: ____________
Joining date: ________ Last working day: ________ Interviewer: ____________
Reasons for leaving (tick the main one, note others)
- Pay or benefits
- Career growth
- Manager or team
- Workload or hours
- Role not as expected
- Location or commute
- Further study or personal reasons
- Another offer
- Other: ____________
Questions
- What made you start looking, or accept the new role?
- What did you like most about working here?
- What would have kept you?
- How was your relationship with your manager? What could they do differently?
- Did you have the tools, information and training you needed?
- Would you recommend us as an employer, and would you return?
- Is there anything the company should change?
Handover and records
- Handover completed and signed off.
- Company assets returned.
- Dues and final settlement date explained.
- Experience or relieving letter timeline explained.
For HR
Main reason (one of the list above): ____________
Is it controllable? Yes / No. Pattern with earlier exits? ____________
A starting point, not legal advice. Check the final wording against your contracts and the rules of your state, and have a qualified professional review it before you issue it.