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Employee Exit Survey
 
 
Add an Employee Exit Survey
We appreciate your taking a few minutes to complete this Exit Survey.
All responses will be held in strict confidence and will be used in our ongoing recruitment and retention program.
How Long (Years and Months)
have you been with
the Agency?
   

   
How Long (Years and Months)
have you been in
your Current Position?
   

   
For Which Program/Center/
Board/Commission
are/were you Working?
 
Are You Leaving?
 
Race Gender
 Please check each statement below which reflect the main reason(s) why you are leaving your current position.
Transferring
Within the
Agency
Returning
to School
Retiring
Transferring
to Another
State Agency
Relocating Career
Opportunity
Going to the
Private Sector
Other
Reason(s)
 
Please check each statement below that strongly influenced your decision to leave your current position.
Leave blank those items that had little or no influence on your decision to leave.
Health
Reasons
(Self)
Job Match
with Skills
Job
Stress
Health
Reasons
(Family)
Relations with
Co-Workers
Workload/
Caseload
Child Care
or Elder Care
Responsibilities
Relations with
Supervisor/Manager
Working Conditions
(Travel, Hours, On Call)
Pay and
Benefits
Other
Influence(s)
 
 
Would You Consider Working for the Agency Again?  
 
 Please Rate the Following Statements Concerning Your Employment with the Agency.
My Supervisor's Expectations, Work Assignments, and Deadlines were Reasonable and Clearly Communicated  
My Supervisor Provided Timely and Useful Feedback About my Job Performance  
My Work Unit Worked Well Together as a Team to Effectively accomplish our Assigned Tasks.  
My Supervisor Allowed and Encouraged my Participation in Training Courses, Conferences, Seminars, and Workshops  
My Supervisor was Effective in Administering his/her Work Unit  
I Completed Several Training Courses Offered by yhe Agency to Improve my Job Skills and my Competiveness for Promotion.
(If not, Please Indicate in the Additional Comments the Courses you Needed and why they were not Available)
 
I was Provided a Good Orientation to the Job and the Agency  
My Opportunities for Advancement in the Agency were Very Good.
(If not, Please Explain in the Additional Comments)
 
My Paycheck was Always Accurate and On Time.
(If not, Please Explain in the Additional Comments)
 
The Agency Provided a Good Employee Benefit Package  
My Work Accomplishments were Recognized  
Work Performance Standards were Reasonable and Applied Fairly  
I Received Adequate Resources to Perform my Job  
I Would Recommend my Section/Unit as a Good Place to Work  
I Would Recommend the Agency as a Good Place to Work  
The COVID-19 Pandemic Influenced my Decision to Leave  
 
Additional Comment or Notes 
This Exit Survey is for the Deputy Director Only, not Human Resources