Q01
Long Text
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Post-Cancellation Exit & Win-Back Survey
Captures structured cancellation feedback from recently churned customers to identify primary churn drivers, unmet value expectations, and win-back levers for product and retention teams.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
19 questions · ~4 min
Q02
Long Text
Before canceling, how often did you typically use the product?
Q03
Multiple Choice
What was the single biggest reason you canceled?
Q04
Long Text
Overall, how well did the product fit your needs?
Q05
Multiple Choice
Which of the following would most increase your likelihood of returning? Select up to three.
Q06
AI Interview
We'd like to understand your cancellation experience in more depth. An AI interviewer will ask you a couple of brief follow-up questions based on your earlier answers.
Q07
Long Text
Based on your responses in this survey, is there anything else you'd like to share about your experience or suggestions for how we could improve?
Q08
Long Text
Which of the following best describes your role?
Q09
Long Text
Thank you for sharing your experience—your feedback will directly inform product and service improvements. We appreciate your time!
Q10
Long Text
How long had you been using the product before you canceled?
Q11
Multiple Choice
Beyond your primary reason above, which of the following were additional contributing factors? Select all that apply.
Q12
Long Text
What value did you expect from the product that you did not experience? Please be as specific as you can.
Q13
Long Text
How likely are you to try our product again in the next 6 months?
Q14
Long Text
Approximately how many employees are in your organization?
Q15
Long Text
If you switched to another provider, which one did you move to? If you did not switch, please type 'N/A.'
Q16
Long Text
If price were a factor in your decision, which monthly price range would make you consider returning?
Q17
Long Text
What industry do you primarily work in?
Q18
Long Text
In your own words, what best describes what led you to cancel?
Q19
Long Text
What region are you located in?
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.