Customer Churn Feedback Survey
With Base Theme

"Customer Churn Feedback Survey"

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Customer Churn Feedback Survey Form Template

Customer retention is as critical as acquisition, and understanding why customers leave is key to maintaining a successful business. Our Customer Churn Survey Form is designed to help you get to the root of customer departures and develop strategies to improve retention.

Beginning with an inquiry into what initially attracted the customer, this form allows businesses to understand their strengths from a customer's perspective. It also includes a satisfaction scale, from 1 to 5, to rate the customer's contentment with the products or services before they decided to leave.

Moreover, the form prompts customers to share whether they tried to resolve any issues before ending their association with your company. This information is crucial for identifying gaps in customer service and product offerings.

Lastly, the form invites departing customers to suggest what could have been done differently to retain their business. Such feedback is invaluable as it provides direct insights into potential improvements and adjustments that could turn dissatisfied customers into loyal ones.

Implement this form on your website to open a dialogue with customers who have canceled your services or returned your products. It's not just a survey; it's an opportunity to transform your business strategy, reduce churn, and enhance customer satisfaction for the long term.

Customer Churn Feedback Survey Features

Boost Customer Retention
Boost Customer Retention
Understand why customers leave with targeted feedback to enhance retention strategies.
Prevent Customer Churn
Prevent Customer Churn
Identify and address issues before they lead to customer loss, improving long-term satisfaction.
Data-Driven Insights
Data-Driven Insights
Gain valuable feedback on product/service satisfaction and issue resolution for informed decision-making.
Enhance Customer Service
Enhance Customer Service
Open a dialogue with departing customers to improve service quality and address concerns effectively.
Strategic Business Growth
Strategic Business Growth
Transform departing customers into loyal advocates by implementing feedback-driven improvements.
Drive Customer Loyalty
Drive Customer Loyalty
Turn dissatisfaction into loyalty by listening to customer suggestions and implementing changes.
Customer Churn Feedback Survey Form Template
Customizable Form Fields
You can add, remove or re-arrange form fields when using our form builder app.
htmlHeading (html-block)
Customer Loss Survey
nameFirst* (text, input)
First Name
nameLast (text, input)
Last Name
email* (email)
buttons* (select, radio)
What attracted you to become one of our customers?
rating* (range, buttons)
On a scale of 1-5, how satisfied were you with our products/services before you stopped using them?
feedback1 (text, textarea)
Did you attempt to resolve any problems or issues you experienced before stopping your use of our products/services? If so, how were they addressed?
feedback2 (text, textarea)
Is there anything that our company could have done to prevent you from stopping your use of our products/services?

Try Out the Form for Yourself!

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The form below is using our "Base" form theme. You can change the colors and the theme using the Wizara Form Builder app.