QUESTIONS

1. Reason for Leaving: What prompted your decision to leave [Your Company Name]? (Please select one)

•  Career Growth Opportunities

•  Compensation

•  Work-Life Balance

•  Workload

•  Relationship with Supervisor/Colleagues

•  Relocation

•  Personal Reasons

•  Other (please specify): ______________________

2. Job Satisfaction: On a scale of 1 to 5, how satisfied were you with your role at [Your Company Name]? (1 = Very Dissatisfied, 5 = Very Satisfied)

3. Work Environment: Please share your thoughts on the work environment, including culture, communication, and collaboration.

4. Supervisor Feedback: How would you rate your relationship with your supervisor? Any specific feedback you'd like to provide?

5. Co-worker Relations: How would you describe your interactions with colleagues? Any suggestions for improving team dynamics?

6. Training and Development: Did you feel adequately trained and supported in your role? Were there opportunities for professional growth?

7. Company Policies: Were you aware of and comfortable with our company policies and procedures?

8. Benefits and Compensation: Were you satisfied with your compensation and benefits package? Any suggestions for improvement?

9. Exit Process: How would you rate the exit process, including HR procedures and the return of company property?

10. Additional Feedback: Is there any other feedback or suggestions you'd like to share regarding your time at [Your Company Name]?

LEGALITIES

Please read and acknowledge the following legalities:

• Return of Company Property: You agree to return all company property, including badges, keys, laptops, and any other items, by February 1, 2050. Failure to do so may result in deductions from your final paycheck.

• Confidentiality: You understand and agree to maintain the confidentiality of any proprietary or sensitive information acquired during your employment at [Your Company Name].

• Non-Compete and Non-Solicitation: If applicable, you acknowledge any non-compete and non-solicitation agreements in place and agree to abide by them.

• Final Paycheck: You will receive your final paycheck, including any accrued vacation or PTO, on February 10, 2050.

• Benefits and COBRA: Information regarding your continued eligibility for benefits and the option to elect COBRA coverage will be provided separately.

• References: [Your Company Name] will provide neutral references upon request. Please inform HR if you do not wish us to disclose any information beyond your dates of employment and job title.

By signing below, you acknowledge that you have read and understood the legalities outlined above.

(signature)

[YOUR NAME]

Date: January 1, 2050

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