Exit Interview Form
Guidance
If you are completing an Exit Interview, please refer to the Exit Interview webpage.
The completed form should be safely and confidentially stored in accordance with the University’s Data
Protection and Records Management guidance.
The person conducting the meeting is accountable for ensuring any agreed actions are implemented and
regularly reviewed. The person conducting the meeting will let the employee know that the information
disclosed will be retained for one year.
You should share a copy of the Exit Interview form with the employee for their own records and agree if any
actions need to be communicated to colleagues and who will do this.
If you require this form in an alternative format please contact the HR Helpline by email at
HRHelpline@[Link].
The following checklist can help you to identify, agree and implement actions:
Checklist: Completed (Y/N):
Planning before the meeting
Check the Leaver Journey to see if employee has completed the Exit Survey task. If
not encourage them to do so.
Familiarise yourself with the relevant policies or guidance. Supporting guidance on
meaningful conversations is available on the Conversations Hub - Home
After the Exit Interview meeting
Reflect on exit interview feedback and any actions agreed.
Complete all the sections of the Exit interview form.
Identify if any actions need to be passed to other teams/ escalated to other
individuals or teams e.g. Estates, H&S, HR, Senior Colleague
Set a date to complete any agreed actions
Share the completed Exit Interview form with the employee
Safely and confidentially store the document (as noted above)
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Section 1: Employee’s details
Please complete all sections below.
Name:
Assignment Number:
College/ Professional Service Group:
School/Department:
Current Job Title:
The individual may be keen to discuss something specific with you, so you should initially allow them
the opportunity to discuss any matters they wish to raise. See the table below for a list of suggested
questions to prompt the conversation. Please note these questions are similar to the questions asked
in the Exit Survey.
Headings Suggested Questions Response
Reason for leaving What are your main reasons for leaving? Is
there anything that would have made you
reconsider leaving?
Role Do you have any suggestions as to how the
job you are leaving could be improved? Did
you feel that you had a manageable
workload?
Relationships with How would you describe your working
line relationship with your line manager and
manager/supervisor colleagues?
and colleagues
Pay and benefits Do you feel that your pay and benefits (e.g.
pension, annual leave entitlement) were
fair for your role?
Communication How did you feel about the level and
quality of communication within your
team/department/school?
Learning and Do you feel that you received adequate
development learning/coaching to perform your role? Do
you feel that you had access to appropriate
development?
Work-life balance Do you have any suggestions as to how
work-life balance could be improved?
Opportunity to Are there any other comments or issues
discuss any other you would like to share about your
issues experience of working here?
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Comments and
discussion from
conversation
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Section 2: Agreed Actions (if required)
Agreed Actions Date to be completed (dd/mm/yyyy)
Section 3: Communications and changes
The Exit Interview form will be kept securely and confidentially by the person conducting the interview. The
employee must be made aware if the detail of the Exit Interview form needs to be shared with colleagues,
whose role is to provide advice on and/or implement the agreed actions. If you require support, please
speak to your HR Partner.
If you are sharing information with colleagues, please tick to confirm that the employee has been made
aware.
Section 4: Conclusion and review
The actions included in this form should be reviewed to ensure the agreed actions have been completed.
The Exit Interview form will be retained for one year in line with the Privacy Notice.
Current date (dd/mm/yyyy):
Review date (dd/mm/yyyy):
Any additional comments:
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