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Thank you for your willingness to take this short exit survey. Please note that your responses will be as confidential as you would like them to be. There are only two questions you must answer: "Position" and "Work Location." You may leave any other question unanswered if you do not wish to respond. For example, if you do not want to provide your name, simply skip the "Name" question. If you answer all of the questions, 18 total, the survey should only take a few minutes to complete.

1. Name

* 2. What is the name of the local agency or operation at which you worked? (Required)

* 3. What is the city and state of the operation?

4. What is your line of business?

5. Please indicate your employment type?

6. Which of the following categories best describes your employment status?

* 7. What was your position with ResCare? (Required)

8. Supervisor's name

9. What was your last day of work?

Date:
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Remember: Your answers are confidential. We NEVER share your name.

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