HelloForms
Product · free template

Customer Churn Survey

Learn why customers cancel — and offer a save path — in six honest questions.

A ready-to-use technology, saas & dev form for engineering, IT and product teams: 9 questions, 1 page, 3 conditional rules.

Questions
9
Pages
1
Layouts
card · classic
Conditional rules
3
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This is the real form. Answer it to test the 2 conditional rules — nothing is sent or stored.

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2 questions are hidden by conditional logic right now — change an answer above to reveal them.

Compliance checklist

Ready to publish
  • Payment items priced — passingEvery payment question charges a real amount, so a submission always records a payment.
  • Conditional logic resolves — passingEvery rule points at a question or page that exists in this template.
  • Legal text not required — passingThis template collects neither health nor regulated financial information.
  • Question labels unique — passingLogic and exports address questions by label, so duplicates are ambiguous.

What happens after submit: nothing is stored in this preview. On your own copy, every response triggers an instant email notification and lands in your response dashboard, ready to export or forward.

Happy with it? Take a copy into your workspace — every question, rule and setting comes with it.

Who this template is for

Customer Churn Survey is built for engineering, IT and product teams who need to route technical requests with the context needed to triage them.

  • Engineering, IT and product teams working in technology, saas & dev.
  • Teams who need to route technical requests with the context needed to triage them without writing code or paying for a custom build.
  • Anyone replacing vague reports that can't be reproduced or prioritised with one structured record per enquiry.
  • Respondents are users, testers and internal stakeholders — the form asks them 9 questions across 1 screen.
  • Mobile-heavy audiences, thanks to the one-question-per-screen card layout.

Why this form is useful

It removes the cost of vague reports that can't be reproduced or prioritised and turns each submission into a record your team can act on immediately.

  • 4 questions are 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.
  • 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 Customer Churn Survey 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 Too expensive, the form dynamically exposes “Would a discount change your mind?”. Otherwise that question never appears.
  • Features conditional validation: if “Primary reason for leaving” is Missing features, “Which features were missing?” becomes mandatory before the form can be sent.
  • Features advanced show logic: if “Primary reason for leaving” is Switching to a competitor, the form dynamically exposes “Which product are you moving to?”. 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.

About this template

A cancellation is the most honest moment in a customer relationship and the one most companies waste on a confirmation screen. Six questions collected at that moment tell you more than a year of satisfaction surveys. The primary reason is a single choice so the data aggregates cleanly, and the branches do the real work: too expensive reveals a discount offer, missing features requires naming them, and switching to a competitor asks which one. Each of those is a different problem with a different owner — pricing, product and positioning respectively. A win-back question separates customers who are gone from those who are pausing, and the return conditions answer is a concrete roadmap input rather than a sentiment. Keep the survey optional and keep the cancellation itself one click away; a survey that blocks the exit produces resentment and dishonest answers in equal measure.

What this form asks

Every question is editable — rename it, make it optional, or delete it entirely.

Before you go

  • How long were you a customer?required
  • Primary reason for leavingrequired
  • Would a discount change your mind?
  • Which features were missing?
  • Which product are you moving to?
  • Overall experiencerequired
  • What could we have done differently?
  • Would you consider returning?required
  • What would bring you back?

9 questions in total.

How the form changes as it's filled in

This template ships with 3 conditional rules, grouped into 3 behaviours driven by 1 question. Everything below is already set up — edit or delete any rule once the template is in your workspace.

Driven by “Primary reason for leaving”

  • Reveals questions

    If “Primary reason for leaving” is Too expensive, the form reveals “Would a discount change your mind?”.

  • Makes answers required

    If “Primary reason for leaving” is Missing features, “Which features were missing?” becomes required before the form can be submitted.

  • Reveals questions

    If “Primary reason for leaving” is Switching to a competitor, the form reveals “Which product are you moving to?”.

Set it up step by step

  1. 1

    Ask at cancellation, not after

    An exit survey emailed a week later gets a fraction of the responses and none of the candour.

  2. 2

    Keep it optional

    Never block the cancel button. Voluntary answers at the exit are more honest and no less numerous.

  3. 3

    Offer the save only where it fits

    A discount offer to someone whose need has ended is noise; to a price-sensitive customer it is a save.

  4. 4

    Route reasons to owners

    Pricing, product and positioning each own a branch of this form — review them separately, monthly.

Mistakes to avoid

  • Making the survey mandatory before cancellation, which produces anger and random answers.
  • Offering the same discount to everyone regardless of reason.
  • Reading only the aggregate reason and never the free text where the actual insight is.

What it pairs with

Most teams don't run this form on its own. These are the forms and systems it sits next to.

What to do with the responses

Route each reason to its owner, extend save offers only where a discount is relevant, and add missing-feature answers to the roadmap.

Works in both layouts

Browse card templatesBrowse classic templates

Forms that overlap this one

These pages cover the same subject ground as the customer churn survey, matched on the words people actually search for.

Frequently asked questions

Does a discount offer work?

For price-driven cancellations it saves a meaningful share. For unmet needs it delays the same outcome by a month.

How many questions is too many?

Beyond about eight, completion drops sharply. Six well-branched questions outperform a long form.

Should sales see these responses?

Yes, especially the competitor answers — they are the most current competitive intelligence you have.

What pairs with this?

The Feature Request Form, so a missing-feature cancellation becomes a tracked backlog item rather than a lost note.

Is the Customer Churn Survey template free to use?

Yes. You can preview and test Customer Churn Survey on this page without an account, and take a copy into your own HelloForms workspace on the free plan. There is nothing to install and no card required to publish it.

What does the Customer Churn Survey template ask for?

It asks 9 questions across 1 page, 4 of which are required. Every question is listed in full further down this page, and each one can be renamed, reordered, made optional or deleted after you copy the template.

Can I edit the Customer Churn Survey form after copying it?

Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the card and classic layouts, restyle it to match your brand, and set who gets notified on each submission.

How does the conditional logic in this technology, saas & dev form work?

3 conditional rules ship with the template: Features advanced show logic: if “Primary reason for leaving” is Too expensive, the form dynamically exposes “Would a discount change your mind?”. Otherwise that question never appears. Features conditional validation: if “Primary reason for leaving” is Missing features, “Which features were missing?” becomes mandatory before the form can be sent. Features advanced show logic: if “Primary reason for leaving” is Switching to a competitor, the form dynamically exposes “Which product are you moving to?”. Otherwise that question never appears. All rules are editable in the Logic tab.

Where do responses to the Customer Churn Survey form go?

Submissions land in your workspace under Submissions, where you can search, filter, label and export them to CSV or PDF. You can also email a notification to your team on every submission and send the respondent an auto-reply.

Can I embed the Customer Churn Survey form on my own website?

Yes. Publish the form and paste the embed snippet into any page or share the direct link. The embedded form resizes to fit its container and loads no advertising or marketing trackers inside the iframe.

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