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Northern Health Online Exit Interview 

PERSONAL INFORMATION

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.(Required.)
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.(Required.)
3.Do you wish to receive a copy of your interview report?(Required.)
4.Employee Information(Required.)
5.Facility Site(Required.)
6.Facility Location(Required.)
7.Age Group
<=20
21-25
26-30
31-35
36-40
41-45
46-50
51-55
56-60
61-65
>=66
Age: 
8.Preferred Gender Identification(Required.)
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.(Required.)
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