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:

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

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* 3. Position:

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* 5. Direct Supervisor:

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* 6. Employment Dates

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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