Northern Health Online Exit Interview PERSONAL INFORMATION Question Title * 1. As you leave your position, Northern Health would like to hear about your experience. You have a unique perspective on the work environment and in order to continue improving, Northern Health has partnered with JUST Checking Resources Inc., www.just-checking.com (third-party) to assist you with your participation in the online Exit Interview. If you encounter problems while completing this Exit Interview, please notify us within the communication channel or by email retentionservice@just-checking.com. Confirm that you have read and understood the above and that you consent to participate in an online exit interview. Yes, I confirm. No (Please Exit the survey now) Question Title * 2. Your feedback will be invaluable helping NH identify strengths and areas for improvement. As such, your exit interview will be shared with your direct supervisor and your Supervisor’s Supervisor. Yes No (if no, do not proceed with the interview) Question Title * 3. Do you wish to receive a copy of your interview report? Yes No Question Title * 4. Employee Information Employee Name (First and Last) Email Address Telephone Number (xxx-xxx-xxxx) Employment Start Date (mm-dd-yyyy) Employment End Date (mm-dd-yyyy) Were you a new grad? (Yes/No) Department Supervisor Name Supervisor Title Question Title * 5. Facility Site Acropolis Manor Atlin Health Centre Atlin Primary Care Clinic Birchview Residences Bulkley Lodge Bulkley Valley District Hospital Burns Lake Primary Care Clinic Chetwynd Hospital and Health Centre Chetwynd Primary Care Clinic Cottonwood Manor Dawson Creek and District Hospital Dawson Creek Health Unit Delta King Place Dunrovin Park Lodge Environmental Health Office Fort Nelson General Hospital Fort Nelson Health Unit Fort St John Hospital Fort St. James Health Unit Fort St. James Medical Clinic Fort St. John Health Unit Fraser Lake Community Health Centre Gateway Lodge Assisted Living Residences Gateway Lodge Long-term Care GR Baker Memorial Hospital Granisle Health Clinic Haida Gwaii Health Centre Haida Gwaii Hospital Hazelton Community Health Heritage Manor II Hospice House Houston Health Care Centre Houston Health Centre Houston Primary Care Clinic Hudson's Hope Health Centre Jubilee Lodge Kitimat General Hospital Kitimat Health Centre Lakes District Health Centre Lakes District Hospital Laurier Manor Mackenzie and District Health Centre Mackenzie and District Hospital Mackenzie Family Health Clinic Maeford Place Martin Manor Masset Community Health McBride and District Hospital McBride Health Unit McBride Medical Clinic McConnell Estate Mills Memorial Hospital Mountainview Lodge Nick Grosse Assisted Living Residence Northeast Regional Office Northern Haida Gwaii Health Centre Northern Haida Gwaii Hospital Northern Health Masset Clinic Northern Health Regional Office (Corporate) Northern Interior Health Unit - Prince George Northern Interior Regional Office Northview Northwest Regional Office Parkside Care Peace Villa Pioneer Lodge Prince George Urgent and Primary Care Centre Prince Rupert Community Health Prince Rupert Regional Hospital Quesnel Community Health Services Quesnel Primary Care Clinic Quesnel Specialized Services Quesnel Urgent and Primary Care Centre Rainbow Lodge Riverside Place Rotary Hospice House Rotary Manor Simon Fraser Lodge Skeena Place Smithers Community Health Southside Health & Wellness Centre St. John Hospital Stewart Health Centre Stewart Primary Care Clinic Stikine Health Centre Stikine Health Centre (Health Unit) Stuart Lake Hospital Stuart Nechako Manor Summit Residence Surerus Place Terrace Health Unit Terraceview Lodge The Meadows The Pines Tumbler Ridge Community Health Unit Tweedsmuir House University Hospital of Northern British Columbia (UHNBC) Valemount Health Centre Vanderhoof Health Unit Virtual Clinic Wrinch Memorial Doctors' Clinic Wrinch Memorial Hospital Other (please specify) Question Title * 6. Facility Location Atlin, BC Chetwynd, BC Dawson Creek, BC Dease Lake, BC Fort Nelson, BC Fort St John, BC Fort St. James, BC Fraser Lake, BC Granisle, BC Hazelton, BC Houston, BC Hudson's Hope, BC Kitimat, BC Mackenzie, BC Masset, BC McBride, BC Prince George, BC Prince Rupert, BC Queen Charlotte, BC Quesnel, BC Smithers, BC Stewart, BC Terrace, BC Tumbler Ridge, BC Valemount, BC Vanderhoof, BC Other (please specify) Question Title * 7. Age Group <=20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 >=66 Age: Age: <=20 Age: 21-25 Age: 26-30 Age: 31-35 Age: 36-40 Age: 41-45 Age: 46-50 Age: 51-55 Age: 56-60 Age: 61-65 Age: >=66 Question Title * 8. Preferred Gender Identification Male Female Other Prefer not to share Question Title * 9. Please tell us the reason(s) that prompted you to leave NH? Please comment or place an "x" in the corresponding box. Choose all that apply. Compensation / Benefits Return to School Management Issues (provide specific details) Family / Personal Reasons Career Advancement Spousal Transfer Lack of Developmental Opportunities Relationship with Peers Retirement Work / Life Balance Job Satisfaction (ie. Autonomy, variety and task significance, recognition etc.) Work Environment (ie. physical conditions, tools, resources, processes/procedures, etc.) Working Conditions (clearly identify which - ie. hrs of work/lack of hours, conflict in the workplace, legal rights) Lay Off (ie. due to re-structure, role elimitation, etc.) Other (when no of the above reasons apply) NEXT SECTION
