The following questions will assist the Interlake-Eastern RHA in measuring the satisfaction of employees, with respect to their work environment. Your opinion is important to us as it will allow the Interlake-Eastern RHA to continuously improve its work environment.

Note that unless you provide consent, your name will not be used when reporting and will remain confidential.

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1. Name: (Required.)

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2. I consent to having my name included with this exit survey.

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3. Position: (Required.)

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4. Site / Location: (Required.)

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5. Direct Supervisor: (Required.)

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6. Employment Dates (Required.)

Date
Date

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7. Reasons for leaving the Interlake-Eastern RHA (please check all that apply):

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8. What could we have done for you to remain an employee with us?

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9. If you could, what would you have changed about your job?

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10. What was the best part of your job?

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11. What did you dislike about your job?

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12. What would you change in the region to help IERHA's retention strategy?

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13. How would you rate your overall experience working for the IERHA?

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