Employee Exit Survey Template

Employee exit survey with 20 questions on reasons for leaving, manager and pay fairness, and workplace stress. Print, hand out, and scan for instant results.

Use this template

Copy this template into your account, then customize it to suit your needs.

This employee exit survey gives HR teams and people managers a structured way to capture honest feedback from departing staff on paper. It works for offboarding meetings, final-day handovers, and remote sites where a printed form is easier to hand out than a login link. The template runs 20 questions across about two pages, mixing rating scales with a few open comment boxes.

What this survey measures

The survey opens by asking leavers to describe their key reasons for leaving in their own words. Rating questions then cover how well skills and resources were used, room for professional growth, pay fairness, and how each person was treated, rewarded, and listened to by their supervisor. Further sections look at teamwork, weekly stress, work-life balance, and the safety, comfort, and overall tone of the workplace. It closes with an open box for suggested improvements and a final question on overall sentiment about the company.

How to use it on paper

Print a copy for each departing employee and include it with offboarding paperwork or hand it out during the exit interview. Ask the person to use a blue or black pen, mark one option per rating question, and write freely in the comment boxes. Collect finished forms in a sealed folder, then scan or photograph them and upload to PaperSurvey, which reads the marked answers and handwriting automatically and turns them into results you can filter and export.

Customize this template

Most teams add their logo, adjust the scale wording, and add or remove questions to match their offboarding process. You can rename departments, add fields for tenure or role, or trim the supervisor section for smaller teams. The layout reflows automatically whenever you change anything, so the paper form always stays clean and scannable.

Preview the PDF above, or use this template to start collecting responses today.

Questions in this template

  1. In your own words, what are at least 3 key reasons for leaving the company?
  2. How effectively were your skills put to use with us?
  3. How easy was it to get the resources you needed to do your job well at this company?
  4. How much room for professional growth did you have at this company?
  5. How well were you paid for the work you did with us?
  6. How fairly were you treated by your superior at this company?
  7. How consistently did your supervisor reward you for your hard work?
  8. How realistic were the expectations of your supervisor?
  9. How reasonable were the decisions made by your supervisor?
  10. How often did your supervisor listen to employees' opinions when making decisions?
  11. How easy was it for employees to disagree with the decisions made by your superior?
  12. How well did your supervisor handle employee problems?
  13. How well did the members of your team work together to reach targets and deadlines?
  14. In a typical week, how often did you feel stressed at work?
  15. How easy was it to balance your working life and personal life while working with us?
  16. How safe did you feel at your employer's workplace?
  17. How comfortable was your employer's work environment?
  18. Was your employer's working environment positive, negative or neutral?
  19. In a few short words what actions could we take to build a better workplace?
  20. Overall, did you like working with us, dislike it or were indifferent?

Get started with PaperSurvey.io

Create, print, and scan paper surveys with automatic data extraction.

Get Started

Start your 14-day free trial now, no credit card required.