Cancellation Survey
Find out why someone is leaving at the moment they decide, and offer the one alternative that might change their mind.
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Opens in the builder. Nothing is saved until you edit it. Or ask Claude or ChatGPT to build it.
- Fields
- 8 questions
- Layout
- Classic, every question on one page
- Theme
- Rose, switchable in the preview
- Updated
- 11 August 2026
Categories
- Marketing form templates
- Survey Forms
- Churn Forms
- Feedback Forms
Form type
Ideal for
- Product teams
- Customer success
- Founders
- Growth teams
Best used in
- Churn analysis
- Subscription cancellation
- Win back campaigns
About this template
The cancellation moment is the only time you will get a completely honest answer about your product, and most companies waste it on a confirmation dialog. A single required reason plus one open field is enough to build a churn breakdown you can actually act on.
The offer question is the part that pays for the form. A meaningful share of cancellations are seasonal or budget driven rather than permanent, and offering a pause or a cheaper plan at exactly the moment someone is leaving saves accounts that no win back email will ever reach.
Ask where they are going, because a name that keeps appearing is competitive intelligence you cannot buy. Keep every option honest, including the one that lets them just cancel, since a form that traps people generates complaints rather than retention.
Templates are a starting point, not legal or professional advice. Where a form carries consent, medical, or contractual wording, have somebody qualified review it against the rules that apply to you before you publish.
Fields in this template
- What is the main reason you are cancelling?*Single choice
- Anything you want to add?*Long text
- If you are switching, what are you moving to?Short text
- If something was missing, what was it?Long text
- Would you consider coming back?Single choice
- Before you go, would any of these help?Single choice
- Email on the account*Email
- AccountHidden field
Every field can be renamed, reordered, made optional, or removed once the template is open in the builder.
Build this form by asking Claude or ChatGPT
Connect Deoochform to Claude, ChatGPT, or any assistant that supports MCP, then send it the message below. It creates the cancellation survey from this template in your account and replies with a link. You can ask it to add, remove, or reword questions in the same chat before you share the form.
Make me a form in Deoochform from your Cancellation Survey template, then send me the link to share.
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Frequently asked questions
- What should a cancellation survey ask?
- The main reason, where they are switching to if they are, what was missing, and anything they want to add. Keep it to a handful, because someone leaving will not fill in a long form.
- When should it be shown?
- At the moment of cancelling, not afterwards. It is the only time the reason is precise, and it is the only time an alternative offer has any chance of being read.
- Should I offer a save attempt?
- One, and make it relevant to the reason given. Conditional logic can show a pause option to someone citing cost and nothing at all to someone who has already switched.
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