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.
Before canceling, how often did you typically use the product?
- Less than once a month
- A few times a month
- About once a week
- A few times a week
- Daily or almost daily
What was the single biggest reason you canceled?
- Price was too high
- Did not get enough value
- Missing critical features
- Bugs or reliability issues
- Switched to a competitor
- Customer support problems
- Hard to use
- Temporary or short-term need ended
- Budget or funding cuts
- Onboarding or setup was difficult
- Data, privacy, or security concerns
- Other (please specify)
Overall, how well did the product fit your needs?
Which of the following would most increase your likelihood of returning? Select up to three.
- Lower price or a more affordable plan
- Add the specific feature(s) I need
- Improve reliability or performance
- Better onboarding and guidance
- Easier integrations with my tools
- More responsive, higher-quality support
- Month-to-month or more flexible billing
- Longer free trial or return discount
- Stronger data privacy and security assurances
- Nothing would bring me back
- Other (please specify)
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.
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?
Which of the following best describes your role?
- Individual contributor
- Team lead or Manager
- Director
- Executive
- Founder or Owner
- Consultant or Freelancer
- Student
- Other
Thank you for sharing your experience—your feedback will directly inform product and service improvements. We appreciate your time!
How long had you been using the product before you canceled?
- Less than 1 month
- 1 to 3 months
- 4 to 6 months
- 7 to 12 months
- More than 1 year
Beyond your primary reason above, which of the following were additional contributing factors? Select all that apply.
- Price was too high
- Did not get enough value
- Missing critical features
- Bugs or reliability issues
- Switched to a competitor
- Customer support problems
- Hard to use
- Temporary or short-term need ended
- Budget or funding cuts
- Onboarding or setup was difficult
- Data, privacy, or security concerns
- None — only my primary reason
What value did you expect from the product that you did not experience? Please be as specific as you can.
How likely are you to try our product again in the next 6 months?
Approximately how many employees are in your organization?
- Just me
- 2 to 10
- 11 to 50
- 51 to 200
- 201 to 1,000
- 1,001 to 5,000
- More than 5,000
If you switched to another provider, which one did you move to? If you did not switch, please type 'N/A.'
If price were a factor in your decision, which monthly price range would make you consider returning?
- Price was not a factor
- Less than $10/month
- $10 – $24/month
- $25 – $49/month
- $50 – $99/month
- $100 – $199/month
- $200 or more/month
What industry do you primarily work in?
- Technology
- Education
- Healthcare
- Finance
- Retail or eCommerce
- Media or Entertainment
- Professional Services
- Nonprofit
- Government
- Other
In your own words, what best describes what led you to cancel?
What region are you located in?
- North America
- Europe
- Asia-Pacific
- Latin America
- Middle East & Africa
- Other
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.
Why this template
What this template is built to do — we found no directly comparable template from other survey tools to review.
What sets it apart
- Includes a dedicated AI follow-up interview segment that can probe deeper into each respondent's specific cancellation story rather than relying only on fixed-choice answers
- Separates the single biggest cancellation reason from secondary contributing factors, plus an open-text narrative on what led to canceling, giving multiple angles on churn drivers
- Directly measures win-back levers with questions on what would increase likelihood of returning, likelihood to re-try within 6 months, and acceptable price ranges
- Captures firmographic context (role, company size, industry, region) so retention teams can segment churn patterns by customer type
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
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