Exit Interview

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First Name:

Last Name:

EMPLOYEE NETWORK USER ID - This is the login ID used to access Northern Light Health network computers, email, etc:

EMPLOYER:


Employee ID:


Direct Supervisor/Leader Name (first and last):


Month of Departure:


Year of Departure:

 
Please choose the reason(s) that best describes why you are leaving your member organization.:

If Other, please list reason:


Please answer each statement below using a 1-5 scale, to identify whether you agree or disagree with each of the following statements regarding your employment within Northern Light Health member organizations.

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1. My rate of pay was fair for the work I performed:


2. I found the quality and quantity of benefits offered to be satisfactory. (i.e. medical, dental, retirement, wellness program(s), paid time off, etc.):


3. There was opportunity for job advancement:


4. There were educational opportunities available to me. (i.e. system workshops, on-the-job training, tuition assistance, etc.):


5. My performance evaluations were accurate, timely, and fair:

6. My job made good utilization of my skills and abilities:


7. I received timely feedback from my supervisor. (i.e. recognition and/or constructive feedback):


8. I understood the mission and values within my organization:


9. I understood how my job contributed to the overall success of my department and the organization:


10. I felt safe in my work environment. (i.e. physical and emotional wellbeing):


11. I understood the policies and procedures and knew where to find them if needed:


12. I was given opportunities to contribute to important decisions in my work area:


13. Changes that affected me were discussed prior to their implementation:


14. My direct supervisor was consistent, available, and approachable:


 15. I would consider working for a Northern Light Health member organization again: 
 
16. I would recommend working here to a friend:


17. I believe my organization was committed to fostering a culture of compliance and ethics:


18. I believe my organization was effective in communicating to me their expectations regarding compliance with policies and procedures and with state and federal laws and regulations, including how to report a compliance concern if I had one:


19. One thing I would have changed about my experience here would be:
20. Additional comments regarding any of the above topics or related to your work experience:
21. Completing the exit interview survey gave me the opportunity to report all violations that I am aware of, relating to the organization’s Code of Conduct, policies, procedures, and legal/regulatory requirements:

I would like to discuss my exit interview with a member of HR:

I have completed this survey accurately and to the best of my ability: