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 has 35 questions across five pages, mixing rating grids and scales with a few open comment boxes.
What this survey measures
The survey opens with the leaver's department, last working day, tenure and role, then asks for the main reason for leaving, the other factors involved and what they will do next. Rating grids cover how well skills, resources and growth opportunities were used, pay and benefits, how each person was treated, rewarded and listened to by their manager, teamwork, safety, workload and work-life balance, and how senior leaders communicated. A short section checks how the exit process itself is going. The overall section asks whether anything could have changed the decision, whether the person would return and how likely they are to recommend the company, and three open boxes close the form.
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, change the reasons for leaving, or trim the manager 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.