LOS ANGELES COUNTY - DEPARTMENT OF HEALTH SERVICES
HUMAN RESOURCES
Please take a few minutes to complete this questionnaire so that we can better understand your reasons for leaving.
This information will enable us to make improvements and is kept confidential and does NOT become part of your Personal
Record. The information provided here after login screen are obtained from HR department. For
more information about this exit interview, request assistance or
instructions, please contact HR staff or call us at 323-890-7903.
Please review your answers carefully before submitting, the passcode provided to you is for one time use only.
Once the form has been submitted, you are not able to alter any change made to your responses, for you will not be allowed to log back
on to this form again.
