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Customer Experience

Customer Churn Risk & Retention Drivers Survey

Identifies at-risk B2B customers through usage patterns, perceived value, and churn intent, then surfaces the retention levers most likely to prevent cancellation. Designed for product, CS, and growth teams managing subscription-based accounts.

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Sample questions

A preview of what’s in the template. Every question is editable before you launch.

23 questions · ~10 min
Q01
Message

Welcome, and thank you for taking part in this brief survey. Your responses will help us understand your experience and improve our product. This survey takes approximately 11 minutes. Your participation is entirely voluntary, and you may stop at any time. There are no right or wrong answers — we are interested in your honest opinions. All responses are confidential and will be reported only in aggregate. Please answer based on your experience over the last 90 days unless a question specifies otherwise.

Q02
Multiple Choice

In the past 30 days, how often have you used our product?

  • Daily
  • Several times a week
  • Weekly
  • 2–3 times a month
  • About once a month
  • Less than monthly
  • Not in the last 30 days
Q03
Opinion Scale

To what extent does our product meet your current needs?

Scale: 1 – 7
Min:Does not meet my needs at allMax:Fully meets my needs
Q04
Opinion Scale

How likely are you to continue using our product over the next 90 days?

Scale: 1 – 7
Min:Very unlikelyMax:Very likely
Q05
Ranking

Please rank up to three actions that would most increase your likelihood to continue using our product.

  1. Lower price or more flexible pricing
  2. Add specific feature(s) you need
  3. Improve reliability or performance
  4. Provide better onboarding or training
  5. Faster, higher-quality support
  6. Easier integrations with other tools
  7. More flexible contract terms
Drag to rank
Q06
Opinion Scale

If you contacted our support team in the last 90 days, how would you rate that experience?

Scale: 1 – 7
Min:Very poorMax:Excellent
Q07
Long Text

Based on your responses in this survey, please share any additional thoughts or suggestions about your experience with our product.

Q08
Multiple Choice

What is your primary role in relation to our product?

  • Day-to-day user
  • Admin/Owner
  • Decision maker
  • Executive sponsor
  • Consultant/Partner
  • Other
Q09
Message

Thank you for completing this survey! Your feedback is valuable and will directly inform how we improve our product. If you have any questions, please contact our team at [support email].

Q10
Multiple Choice

Compared with three months ago, how has your usage changed?

  • Increased a lot
  • Increased a little
  • No change
  • Decreased a little
  • Decreased a lot
  • Stopped using entirely
Q11
Opinion Scale

How easy or difficult is it to accomplish your goals using our product?

Scale: 1 – 7
Min:Very difficultMax:Very easy
Q12
Opinion Scale

How likely are you to recommend our product to a colleague or peer?

Scale: 1 – 7
Min:Very unlikelyMax:Very likely
Q13
Dropdown

Which of the following best describes the monthly price that would feel fair for the value you currently receive?

  • Less than $10
  • $10 – $24
  • $25 – $49
  • $50 – $99
  • $100 – $249
  • $250 – $499
  • $500 – $999
  • $1,000 or more
  • Not sure / prefer not to say
Q14
Multiple Choice

Did you contact our support team in the last 90 days?

  • Yes
  • No
Q15
AI Interview

We'd like to understand a bit more about your experience. An AI moderator will ask a couple of brief follow-up questions.

Q16
Multiple Choice

Approximately how many employees are in your organization?

  • 1–10
  • 11–50
  • 51–200
  • 201–1,000
  • 1,001–5,000
  • 5,001+
Q17
Opinion Scale

How much would you miss our product if you no longer had access to it?

Scale: 1 – 7
Min:Would not miss it at allMax:Would miss it a great deal
Q18
Multiple Choice

What are the main reasons you might cancel or reduce your plan? (Select all that apply.)

  • I no longer need the product
  • Missing key features
  • Too complex or hard to use
  • Performance or reliability issues
  • Poor support experience
  • Price or cost is too high
  • Switching to another provider
  • Budget cuts or approvals blocked
  • Security, privacy, or compliance concerns
  • I am not considering cancellation
  • Other (please specify)
Q19
Multiple Choice

How long has your organization been using our product?

  • Less than 1 month
  • 1–3 months
  • 4–12 months
  • 1–2 years
  • 3+ years
  • Not sure
Q20
Opinion Scale

How would you rate the overall value for money you have received from our product over the last 90 days?

Scale: 1 – 7
Min:Very poor valueMax:Excellent value
Q21
Multiple Choice

If you were to stop using our product, what would you most likely do instead?

  • Switch to a competing product
  • Build an internal solution
  • Use a manual workaround
  • Do without any solution
  • Not sure
Q22
Multiple Choice

Which subscription plan are you currently on?

  • Free/Trial
  • Paid monthly
  • Paid annually
  • Not sure
Q23
Multiple Choice

Which of the following capabilities are currently missing or difficult to use? (Select all that apply.)

  • Reporting and analytics
  • Collaboration/sharing
  • Mobile access
  • Integrations with other tools
  • Customization/flexibility
  • Admin controls and permissions
  • Performance/speed
  • Onboarding or education
  • Documentation or self-serve help
  • Other (please specify)
  • None of the above

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.

How it compares

We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.

Why this template

  • Includes a full B2B firmographic profile (role, company size, tenure, plan) so churn signals can be segmented by account type
  • Combines quantitative churn-risk metrics (usage change, perceived value, likelihood to continue, NPS) with a ranked list of retention levers respondents would actually respond to
  • Adds an AI follow-up interview that can probe open-ended cancellation reasons and support experiences in real time rather than relying on a single static open-text box
  • Captures pricing sensitivity, support experience, and specific missing capabilities in the same flow, giving product, CS, and growth teams one dataset instead of three separate surveys

Jotform

Customer Churn Survey Form Template

A ready-to-use churn survey form built on Jotform's drag-and-drop form builder, likely covering basic satisfaction and cancellation reasons. It's a static form template meant to be customized rather than a purpose-built B2B retention diagnostic. No indication of AI-driven follow-up or account segmentation built in.

What it does well

  • Quick to deploy and customize within Jotform's existing form ecosystem
  • Familiar drag-and-drop builder likely to be easy for non-technical teams
  • Can integrate with Jotform's broader form/workflow features (payments, notifications, etc.)

Where it falls short

  • Static question set with no adaptive follow-up probing into individual churn reasons
  • No built-in B2B segmentation (role, company size, plan tier) apparent from the template
  • No automated quality scoring or auto-generated retention-driver report

SurveySparrow

Customer Retention Survey Template

A conversational-style retention survey template aimed at general customer retention rather than B2B subscription churn specifically. Likely covers satisfaction and loyalty questions in SurveySparrow's chat-like format, but doesn't appear tailored to usage-pattern-based churn risk scoring or account-level B2B context.

What it does well

  • Conversational chat-style format may improve completion rates
  • Positioned within a broader marketing/retention template library
  • Likely supports basic branching logic for follow-up questions

Where it falls short

  • No adaptive AI-moderated interview to dig into individual churn drivers
  • Template appears generic to retention rather than tuned to B2B usage/value/churn-intent scoring
  • No transparent published methodology or automated report generation for retention levers

Typeform

Customer Retention Survey Template

A polished, conversational one-question-at-a-time retention survey template, good for general customer feedback collection. It doesn't appear to include B2B-specific segmentation or a structured churn-risk model (usage change, likelihood to continue, ranked retention levers) like this template does.

What it does well

  • Clean, engaging one-question-at-a-time UI known for high completion rates
  • Easy integration with other tools via Typeform's ecosystem
  • Good general-purpose design for customer feedback

Where it falls short

  • No adaptive AI follow-up interview or voice interview option to probe churn reasoning
  • No visible ranking mechanism for prioritizing retention levers
  • No automated per-response quality scoring or auto-generated churn report

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Open this template in the editor. Every part is yours to change before the first respondent sees it.

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