Culture Exit Survey Template
Measure how culture contributed to a departure. Recommended timing: final working week or within one week after leaving.
What this survey is for
Detect culture problems that quietly push good people out.
Example questions
- 1
I felt like I belonged at this company.
Opinion scale
- 2
The company lives the values it promotes.
Opinion scale
- 3
People here treated each other with respect.
Opinion scale
- 4
Which cultural factor most influenced your decision to leave?
Single choice
- 5
Describe the culture here in your own words.
Open text
- 6
What one cultural change would make the biggest difference?
Open text
- Send the culture exit survey at the moment it's most relevant to the respondent.
- Keep it short — every extra question lowers completion.
- Always include at least one open-text question so AI can surface themes.
- Segment responses by audience and touchpoint to find what to fix first.
- Close the loop with respondents when you act on their feedback.
Frequently asked questions
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