Cancellation / Churn Survey Template
The Cancellation / Churn Survey is a free survey template with 4 questions, 2 of them required. Preview every question on this page without an account, then copy it into Survtapp, change any wording, and start collecting answers on the web or on a tablet.
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What is in the Cancellation / Churn Survey template?
The Cancellation / Churn Survey template holds 4 questions, 2 of which must be answered before it can be submitted and 2 of which are optional. Between them they capture single-choice answers, an agreement scale, longer written comments and yes-or-no answers.
Broken down by field type, the Cancellation / Churn survey is 1 choice questions, 1 comment boxes, 1 pass/fail checks and 1 rating scales.
The 1 choice question in the Cancellation / Churn survey between them offer 6 preset answers, and every one of those labels is editable — the wording listed below is a starting point, not a fixed list.
When should you use the Cancellation / Churn Survey template?
The Cancellation / Churn Survey is filed under “Churn”, “Cancellation” and “Retention”, in the Technology & SaaS part of the library, where it is aimed at product and customer teams who need the answers in a dashboard, not an inbox. Find out why customers leave so you can reduce churn.
Surveys get answered wherever the respondent already is — a link in an email, a QR code on a receipt, a tablet handed across a counter, or a kiosk-locked device left on a stand. At 4 questions, only 2 of them required, the Cancellation / Churn survey is short enough to finish in one sitting, which is what keeps completion rates up.
Does the Cancellation / Churn Survey work offline?
Yes. Once the Cancellation / Churn Survey is published, the 4 fields and every answer option are stored on the device, so the survey opens and completes with no connection at all. Each response is written to the device first and queued; when signal returns it syncs on its own, keeping the time it was actually captured rather than the time it uploaded.
Because all 4 fields in the Cancellation / Churn Survey are text and choice inputs, a queued response is tiny and syncs the moment any connection appears — a shared hotspot is plenty. Kiosk mode locks a tablet to this survey alone, so the next person cannot wander into anything else.
How do you customise the Cancellation / Churn Survey template?
Open the Cancellation / Churn survey in the builder and all 4 questions land as editable fields — nothing is locked to the template. Rewrite the wording, drag fields into a different order, flip any of the 2 required fields to optional (or the other way round), and add anything missing from the 20+ field types in the builder.
The Cancellation / Churn survey's 6 preset answers are the fastest thing to make your own: swap in your own product names, sites or departments and it reads as if you wrote it from scratch.
The Cancellation / Churn Survey runs on a single screen as it stands. Add a page break to split its 4 fields across several, or conditional logic to hide fields that an earlier answer has made irrelevant.
Nothing about the Cancellation / Churn Survey stays Survtapp-branded, either: your logo, your colours and your own URL slug replace ours, so the 4 fields you publish read as part of your own site rather than as a template someone downloaded.
What happens to the responses you collect?
Every response from the Cancellation / Churn survey lands in one place with its timestamp, the agent who collected it and, where the device allows, where it was captured. From there rating answers are averaged and charted, each of the 1 choice question gets a bar or pie breakdown, pass and fail counts are totalled per check and written comments are listed in full rather than summarised away.
Export the lot to CSV, Excel, JSON or PDF whenever you want it elsewhere, or set a trigger so a response from the Cancellation / Churn Survey emails the right person the moment it arrives. Data is held in Canada, the responses stay yours, and you can export or delete them at any time.
What are the 4 questions in the Cancellation / Churn Survey?
Here is every field in the order a respondent meets it, with the answer type it uses. Nothing here is fixed — the list is where you start, not what you are stuck with.
- 1
What is the main reason you are cancelling?required
Single choice — Too expensive, Missing features, Found an alternative, No longer needed, Poor support, Other
- 2
How likely were you to recommend us before deciding to leave?required
Scale
- 3
What could we have done to keep you?
Long text
- 4
Would you consider returning in the future?
Yes / No
How do you start using the Cancellation / Churn Survey?
Preview it. Read all 4 questions in the Cancellation / Churn Survey on this page. No account is needed to preview a template.
Copy it into your account. Create a free Survtapp account and use the template. The Cancellation / Churn Survey arrives as an editable survey, not a locked copy.
Make it yours. Rewrite the wording, reorder the Cancellation / Churn survey's 4 fields, adjust which of the 2 required ones stay required, and apply your logo and colours.
Publish and collect. Share a link or QR code, or open the Cancellation / Churn Survey on a tablet in kiosk mode. It collects responses offline and syncs when the device reconnects.
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How will the Cancellation / Churn Survey look to the person filling it in?
This is the live preview, rendered with the same field widgets the published survey uses. It is read-only here, and your own logo and colours replace ours once it is in your account.
Which templates are like the Cancellation / Churn Survey?
These share a tag with it in the free library, so they tend to suit the same job. Every one is free to preview without an account.
- Employee Exit Interview SurveyUnderstand why employees leave and how to retain future talent.
- Free Trial Cancellation SurveyLearn why trials don’t convert so you can improve activation.
Or browse every free form template, or just the ones tagged Churn.
Questions, answered plainly
How many questions are in the Cancellation / Churn Survey template?
The Cancellation / Churn survey has 4 questions, 2 of them required and 2 optional. You can add, remove or reorder any of them once the template is in your account.
Is the Cancellation / Churn Survey template free to use?
Yes. All 4 questions in the Cancellation / Churn survey are free to preview here with no account, and the template is free to copy into Survtapp. A free account is enough to customise and publish it; the pricing page lists what each plan includes.
Can I change the questions in the Cancellation / Churn Survey?
Yes — all 4 fields in the Cancellation / Churn Survey are editable. Rewrite any question, relabel any of the 6 preset answers, change which fields are required, reorder them, and add fields from the 20+ types in the builder.
Does the Cancellation / Churn Survey work without an internet connection?
Yes. The Cancellation / Churn survey and all 4 of its fields are cached on the device, so it opens and completes offline. Each response queues locally and syncs automatically when the connection returns, keeping its original capture time.
What devices can the Cancellation / Churn Survey be filled in on?
Any modern browser, plus the Survtapp iOS and Android apps. The Cancellation / Churn survey's 4 fields can run on a shared kiosk-locked tablet, on a link people open on their own phone, or behind a QR code on a poster or a receipt.
Who can see the responses collected with the Cancellation / Churn Survey?
Only the people in your account you give access to, per their role. Every answer to the Cancellation / Churn survey's 4 fields is stored in Canada, is never sold, and can be exported to CSV, Excel, JSON or PDF — or deleted — at any time.