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Exit Interview Survey

Reduce turnover with confidential departure insights on management, culture, and compensation

9fields
4pages
10-15 minutes
exitinterviewhrretention
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uplup.com/p/9p3o11jt

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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

Cover Page
Page 1
Page 2
Page 3
Thank You Page

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

1

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.

2

Customize It

Edit the fields, update the design, add your branding, and set up integrations. Everything is editable from the visual builder.

3

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?
Yes, with one edit. The template ships with required name and email fields so HR can connect feedback to a specific departure, but you can delete both in the editor if anonymous responses will get you more candid answers about management and culture.
How long does the survey take a departing employee?
About 10 to 15 minutes. Most of the nine fields are quick picks: three dropdowns covering department, tenure, and reason for leaving, a 1 to 5 experience rating, and one multiple choice question about recommending the company. Typing is limited to the name and email fields plus the two optional comment boxes on what they enjoyed and what could be improved.
Can I export exit interview data for turnover reporting?
Yes. Every submission lands in the Uplup dashboard with per-question breakdowns, you can download the full response set as a CSV, and webhooks or Zapier can push new responses into your other tools as they arrive.

Ready to Use This Form Template?

Customize the fields, add your branding, set up integrations, and start collecting responses today.