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Customer Experience

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 · ~9 min
Q01
Message

Thank you for taking a few minutes to share your cancellation experience. This survey is voluntary and should take about 9 minutes. Your responses are confidential, will be reported in aggregate, and will help us improve our product and services. There are no right or wrong answers—we simply want your honest feedback. You may stop at any time.

Q02
Dropdown

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
Q03
Multiple Choice

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)
Q04
Opinion Scale

Overall, how well did the product fit your needs?

Scale: 17
Min:Not at all wellMax:Extremely well
Q05
Multiple Choice

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)
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
Dropdown

Which of the following best describes your role?

  • Individual contributor
  • Team lead or Manager
  • Director
  • Executive
  • Founder or Owner
  • Consultant or Freelancer
  • Student
  • Other
Q09
Message

Thank you for sharing your experience—your feedback will directly inform product and service improvements. We appreciate your time!

Q10
Dropdown

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
Q11
Multiple Choice

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
Q12
Long Text

What value did you expect from the product that you did not experience? Please be as specific as you can.

Q13
Opinion Scale

How likely are you to try our product again in the next 6 months?

Scale: 17
Min:Extremely unlikelyMax:Extremely likely
Q14
Dropdown

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
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
Dropdown

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
Q17
Dropdown

What industry do you primarily work in?

  • Technology
  • Education
  • Healthcare
  • Finance
  • Retail or eCommerce
  • Media or Entertainment
  • Professional Services
  • Nonprofit
  • Government
  • Other
Q18
Long Text

In your own words, what best describes what led you to cancel?

Q19
Dropdown

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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