Exit Interview Questionnaire

Effective 07/2010 Questions about this form?
Contact HRS Employee Relations Phone: 773-702-8900
EXIT INTERVIEW QUESTIONNAIRE

As you leave the University, you have a unique perspective on the strengths and weaknesses of our organization. The information you furnish is confidential and will be used in summary form as a means to identify patterns or trends in the work environment at the University. Your honesty is greatly appreciated, and your opinions are highly valued. If there is a particular item to which you do not feel comfortable responding, leave it blank and go on to the next. Thank you for your time and effort. 1. Please rank the top five reasons that led to your decision to leave the University. Place a 1 in front of the item that is most important, a 2 in front of the next most important, and so on. Do not use any number more than once. If there are fewer than five reasons, rank just those reasons. Higher salary Career advancement/change Lack of child care Received an employment offer without actively seeking another job Dissatisfied with organizational culture Dissatisfied with job Retirement Other: Non-competitive benefits Transportation problems Dissatisfaction with supervision Lack of job security Dissatisfied with hours Unresolved complaint
2. Please rank the top five items listed below in their order of importance to you. Place a 1 in front of the item that is most important to you, a 2 in front of the next most important, and so on. Do not use any number more than once. Having a good boss Good benefits Flexible working environment Good relationships with co-workers Other: Good salary Opportunities to grow and learn professionally Recognition for skills and accomplishments Working with up-to-date technology
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Effective 07/2010 Questions about this form? Contact HRS Employee Relations Phone: 773-702-8900

3. In this section, please assess supervision in your Division/Department. Excellent Provided feedback on my performance. Treated me with respect and courtesy. Led by example. Helped me solve problems. Was available when I needed help. Followed policies and practices and applied them fairly. Provided positive feedback and recognition. Resolved complaints and problems. Represented the position accurately when interviewed. Training opportunities were available inside the department. Training opportunities were available outside the department. Comments: Good Fair Poor
4. In this section, please assess your working conditions. Excellent My physical work area was appropriate for the work that I did. I had adequate materials to do my work (tools, computer, phones, etc.). My work schedule was convenient. Overtime demands were reasonable. Relationship with co-workers. Relationship with customers (patients, students, faculty, other staff members). Office atmosphere and morale. Adequate guidance in resolving work-related or personal problems. Comments: Good Fair Poor
5. 6. 7.
Would you recommend the University to a friend as a good place to work? Yes
No No
Before making your decision to leave, did you investigate the possibility of a transfer? Yes
If you left for another position, are the job duties in your new position different? (Please circle one)
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Same duties 8. Different duties What did you like best about working at the University?
9.
What did you like least about working at the University?
10.
May we share your responses with your former Division/Department? (Please circle one) Yes
No
11.
Any additional comments? We are particularly interested in any suggestions for improving work procedures or the work environment at the University.
12. 13.
Sex check one box Black
Male
Female
(Non-Hispanic) Persons having origins in any of the Black racial groups of Africa White (Non-Hispanic) Persons having origins in any of the original peoples of Europe, North Africa, of the Middle East) Hispanic Persons of Mexican, Puerto Rican, Cuban, Central or South America, or other Spanish cultures or origin regardless of race American Indian/Alaskan Native Persons having origins in any of the original people of North America, and who maintain cultural identification through tribal affiliations or community recognition. Asian/Pacific Islander Persons having origins in any of the original people of the Far East, Southeast Asia, the Indian Subcontinent or the Pacific Islands. This area includes, for example, China, India, Japan, Korean, the Philippine Islands, and Samoa.
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OPTIONAL Please provide the following information. Leave blank those items that you do not wish to complete. Name: _____________________________________________________________________ Division/Department: _________________________________________________________ Date hired into University: _________________________________ Date hired in above: _________________________________ Last day worked in Division/Department: ________________________________ Supervisors name: __________________________________________________ Job title: ___________________________________________________________ If you wish to talk with someone from Human Resources Management, how may we contact you? Telephone: _____________________________________________________ Address: _______________________________________________________________________________ E-mail: _________________________________________________________ Thank you for participating and telling us about your experience. Please return questionnaire in the enclosed envelope. Revised April 2000
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Effective 07/2010 Questions about this form?

Contact HRS Employee Relations Phone: 773-702-8900

EXIT INTERVIEW QUESTIONNAIRE

EXIT INTERVIEW QUESTIONNAIRE

EXIT INTERVIEW QUESTIONNAIRE

What did you like least about working at the University?

Sex check one box Black

EXIT INTERVIEW QUESTIONNAIRE

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