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Customer Exit Survey Document Template

Survey to collect insights from customers who cancel or stop using a service.

Customer Exit Survey

Purpose: This survey is designed to gather insights from customers who have decided to cancel or stop using our service. Your feedback helps us understand your experience and make improvements.

Customer Information

Name: {name}

Email: {email}

Account ID: {accountId}

Service Used: {serviceName}

Date of Cancellation: {cancellationDate}

Reason for Leaving

Main Reason: {mainReason}

Other Contributing Factors:

{#otherReasons}

  • {reason}

{/otherReasons}

User Experience

Rate your overall satisfaction (1-5): {satisfactionRating}

What did you like most about the service?

{positiveFeedback}

What could we have done better?

{improvementSuggestions}

Customer Loyalty and Retention

Would you consider returning in the future? {returnLikelihood}

If yes, under what conditions?

{#returnConditions}

  • {condition}

{/returnConditions}

Would you recommend our service to others? {wouldRecommend}

{#recommendationReason}

Why or why not?

{recommendReason}

{/recommendationReason}

Final Thoughts

Any additional comments or suggestions?

{finalComments}

Survey Completed By

Name Position Date
{#submittedBy}{name}{position}{date}{/submittedBy}

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Use Cases

Automate Customer Exit Survey Using Forms

collect customer cancellation feedback using a branded exit survey form
share customer exit survey form link via email after service cancellation
embed exit survey form on account deletion confirmation page
use secure online form to collect customer offboarding insights
gather service cancellation reasons through mobile-optimized exit form

Generate Customer Exit Survey Using APIs

auto-generate customer exit survey when subscription is canceled via API
trigger exit feedback document creation from CRM system using API
send real-time exit survey generation requests from billing software API
generate personalized exit interview documents via API from helpdesk system
create downloadable exit feedback reports programmatically via REST API

Integrations / Automations

automatically send customer exit survey using Zapier when user cancels in Stripe
trigger exit survey workflow in Make when contact unsubscribes from Mailchimp
generate and email exit survey form when support ticket is tagged as 'cancelled' in Zendesk
send exit survey via Slack when user status changes to churned in Salesforce
auto-generate and save exit response PDFs to Google Drive using Zapier integration

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