Exit Interview Survey
Reduce turnover with confidential departure insights on management, culture, and compensation
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What's Included in This Template
9 Fields
Pre-configured fields with the right input types, validation, and layout for feedback.
Full Customization
Change colors, fonts, add your logo, rearrange fields, and make it match your brand perfectly.
42+ Integrations
Connect with Mailchimp, HubSpot, Zapier, n8n, Google Sheets, Slack, and more. Automate your workflow.
Form Structure
Multi-page layout keeps your form organized and easy to complete.
Someone hands in their notice and the clock starts. Between the handover plan, the equipment checklist, and the farewell card, the actual exit conversation gets improvised in a rushed final week, if it happens at all. Then the next resignation lands and nobody can say whether the two departures share a cause. This template gives HR teams a standing, confidential survey to send the moment a resignation is confirmed, so the reasons behind turnover get recorded while they are still fresh.
Three resignations, one pattern you can finally see
Picture a 40-person company that loses three people in a single quarter. Each manager has a theory: one blames the job market, one blames salary, one just shrugs. Send every departing employee the same nine-field survey and the guesswork stops. When two of the three pick Compensation as their reason for leaving and rate their overall experience a two out of five, you are no longer weighing anecdotes, you are reading a trend. Uplup breaks responses down per question, so the pattern surfaces without anyone building a spreadsheet.
Nine fields that map a departure
The survey collects name and email, then places the person in context: a Department dropdown with seven options from Engineering to Operations, and a Tenure question with bands from less than a year to five-plus. The core is the Reason for Leaving selector, with choices including new opportunity, compensation, work-life balance, and management, backed by a 1 to 5 Overall Experience rating and a recommendation question with answers running from Definitely to Definitely not. Two optional comment boxes, What did you enjoy most and What could be improved, give people room to say what the dropdowns cannot. The structure spreads across a cover page, three content pages, and an ending page, and completing it takes 10 to 15 minutes.
Reshape it for your org before the first send
Every field is editable, so you can swap the department list for your actual org chart, add a question about where the person is headed next, or remove the name and email fields entirely if anonymity will get you more honest answers. The template runs in traditional page-by-page mode by default, which suits a reflective survey like this one, though conversational mode is a single toggle away if you prefer one question at a time. When it is ready, share it as a direct link, embed it on an internal page, or drop it into a WordPress intranet with the Uplup plugin's shortcode. Responses gather in one dashboard with per-question breakdowns, CSV export feeds whatever retention reporting you already run, and webhooks or Zapier can push each submission wherever your HR stack lives. The template sits on the Business plan, and you can restyle it with your own logo and colors so departing employees see a familiar brand, not a generic form.
Who Is This Template For?
This template works for a wide range of goals and industries.
Resignation debriefs
Send the survey the day a notice is confirmed so the departing employee's reason for leaving, tenure, and overall experience rating are captured before the final week blur sets in.
Quarterly turnover reviews
Aggregate the Reason for Leaving and recommendation answers across every departure in a quarter, then bring per-question breakdowns to leadership instead of competing manager theories.
Small HR teams without an HRIS
Run a consistent offboarding feedback process with a link and a dashboard: no extra software, and CSV export when you need the data somewhere else.
Key Features
Structured reasons for leaving
A seven-option Reason for Leaving selector, department dropdown, and tenure bands turn messy departure stories into data you can compare across people and quarters.
Ratings plus open comments
A 1 to 5 Overall Experience rating and a Definitely-to-Definitely-not recommendation question sit alongside two optional comment boxes for what worked and what did not.
Analytics that surface patterns
Per-question breakdowns show which answers cluster, CSV export feeds your retention reporting, and webhooks or Zapier forward each new response automatically.
How It Works
Choose This Template
Click "Use This Template Free" to get started. You will get a full copy of this form in your account, ready to edit.
Customize It
Edit the fields, update the design, add your branding, and set up integrations. Everything is editable from the visual builder.
Share & Collect Responses
Publish your form and share it with a link, embed it on your website, or post it on social media. View responses in real time.
Frequently Asked Questions
Can exit interview responses be anonymous?
How long does the survey take a departing employee?
Can I export exit interview data for turnover reporting?
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