Exit Interview


Graduate Name:

Email Address:   Phone Number:  

Gender:   Ethnicity:  




Method of Payment:  


Place of Employment:  

Name of Employer/Contact Person:  

Business Street Address:  

City:    State:    Zip Code:  

Business Phone Number:   Business Fax Number:  

Business E-Mail:  

Job Title:  

Please List Four Job Duties:

Job Duty #1:  

Job Duty #2:  

Job Duty #3:  

Job Duty #4:  

Wage Per Hour:    Total Hours per Pay Period:  

Does the Student Need Placement Assistance?  


Please respond to the following:
INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Select the rating from the dropdown that indicates the extent to which you agree with each statement. Please do not skip any item. Any question scored less than 3 requires explanation or if you wish to leave additional comments, please describe in the box below the statement. All graduates must complete this survey to receive their transcript and certificates.

5 = Strongly Agree 4 = Agree 3 = Acceptable 2 = Disagree 1 = Strongly Disagree

General Evaluation

I was informed that I would receive a program certificate of completion after completing all requirements.  

The program adequately prepared me for employment.  

The clinical externship portion of the program adequately prepared me for employment, if applicable.  

Upon completion of my classroom training, an externship site was available to me, if applicable.  

Admissions staff are knowledgeable in programs and provide courteous service.  

The course content is consistent with the program’s goals.  

I would recommend this program/institution to friends or family members.  

Instructor Evaluation

My instructors were knowledgeable in the subject matter and relayed this knowledge to the class.  

The instructor’s development and presentation of material is consistent with the syllabus.  

The instructor explains concepts clearly and in an organized manner.  

The instructor encourages group interaction and critical thinking.  

The instructor provided adequate feedback in a timely manner.  

I, , acknowledge upon MedCertify receiving this Graduate Survey my Transcript(s) and Certification(s) will be delivered to me. I acknowledge I have had the opportunity to express my thoughts in writing concerning my education with MedCertify. I also authorize and give consent to MedCertify to contact my employer for employment verification information needed for state licensure compliance as well as federal and authorized workforce agencies for career placement records. 

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Signature Certificate
Document name: Exit Interview
lock iconUnique Document ID: 0dfa396f4efad9e2f4bb7f1d2139b9e9bd4cc4e4
Timestamp Audit
February 8, 2022 3:49 PM EDTExit Interview Uploaded by MedCertify Education - [email protected] IP
February 15, 2022 2:01 PM EDTMedCertify Edu - [email protected] added by MedCertify Education - [email protected] as a CC'd Recipient Ip:
August 25, 2022 9:54 AM EDTMedCertify Edu - [email protected] added by MedCertify Education - [email protected] as a CC'd Recipient Ip:
September 23, 2022 10:48 AM EDTMedCertify Edu - [email protected] added by MedCertify Education - [email protected] as a CC'd Recipient Ip:
October 27, 2022 10:24 AM EDTMedCertify Edu - [email protected] added by MedCertify Education - [email protected] as a CC'd Recipient Ip: