Churn Exit Survey Form — shared by the community

Who this template is for

Churn Exit Survey Form is built for product, support and customer-experience teams who need to measure satisfaction and capture the reason behind every score.

• Product, support and customer-experience teams working in surveys & feedback.
• Teams who need to measure satisfaction and capture the reason behind every score without writing code or paying for a custom build.
• Anyone replacing ratings with no context, so nothing actionable comes out of them with one structured record per enquiry.
• Respondents are customers, users and members — the form asks them 8 questions across 2 screens.
• Mobile-heavy audiences, thanks to the one-question-per-screen card layout.

Why this form is useful

It removes the cost of ratings with no context, so nothing actionable comes out of them and turns each submission into a record your team can act on immediately.

• 1 question is required, so submissions arrive complete instead of needing a follow-up email.
• It scores satisfaction on a consistent scale.
• Conditional logic hides 3 questions until they are relevant — shorter forms convert better than long ones.
• Splitting the form across 2 pages keeps each screen short and shows respondents how much is left.
• Every response is stored, searchable and exportable, so nothing depends on one person's inbox.

How to use this template

From copy to live form is a few minutes of work, and every step is reversible.

1. 1Press “Use this template” — a fresh copy of Churn Exit Survey Form lands in your workspace, ready to edit.
2. 2Rename or delete any question, and change what is required. Nothing here is fixed.
3. 3Open Notifications and add the email addresses that should be alerted on each submission; add an auto-reply to the respondent if the form collects an email address.
4. 4Publish it, then either share the link directly or paste the embed snippet into your site — the embedded form resizes to fit and loads no marketing or advertising trackers.
5. 5Watch responses land in Submissions, where you can filter, label and export them to CSV or PDF.

Logic and conditions blueprint

Exactly how this form behaves as it is answered — 3 conditional rules ship with it.

• Features advanced show logic: if “Primary reason for leaving” is Switched to a competitor, the form dynamically exposes “Which product did you switch to?”. Otherwise that question never appears.
• Features advanced show logic: if “Primary reason for leaving” is Missing a feature I need, the form dynamically exposes “Which feature was missing?”. Otherwise that question never appears.
• Features advanced show logic: if “Would you consider coming back in the future?” is Yes, possibly, the form dynamically exposes “May we contact you to follow up?”. Otherwise that question never appears.
• All 3 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.