Employee Exit Survey

1. Why did you resign your position with the Health Care Authority?*

2. How would you rate the following on a scale of 1 to 5?

2a. The quality of training you received*

2b. The quality of supervision you received*

2c. The extent to which your skills were utilized*

2d. Availability of resources to perform your job*

2e. The overall work environment*

2f. The co-operation/friendliness of work environment*

2g. The cultural sensitivity of staff and management*

2h. The physical work environment*

2i. The benefit plans available*

2j. The leave policy and opportunity to take leave*

3. Would you recommend HCA as a place to work?

3. Please choose an option.*

Yes
No

3a. Why/ why not?*

4. Is there any particular practice or working condition that led to your resignation or you feel is detrimental to a satisfactory working situation?*

5. What one recommendation would you suggest to make HCA a better place to work?*

6. Additional comments regarding HCA.*

7. Other information

(Optional)

7a. Name

7b. Division

7c. Hire date with HCA: MM/DD/YY

7d. Position when hired.

7e. Position at resignation.

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