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Exit Interview
Name (optional)
First
Last
Supervisor (optional)
First
Last
Department
Position
Why are you leaving the company?
Personal Reasons
Medical Benefits
Quality of Supervision
Work Environment
Other
Please explain your reasons for leaving in more detail.
What suggestions for improvement do you have for us?
If we implement those suggestions, would you return to work here?
Yes
No
Maybe
Would you recommend this company to your friends as a good place to work?
Yes
No
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