Cancellation Survey
Capture why customers cancel in a structured way — from the main reason and their satisfaction at exit to the conditions that would win them back.
Take the template with one click, adapt it to your project in a few minutes and start collecting answers.
Why this template
Adapted in minutes
Change, add or remove questions — the AI assistant rephrases them on request.
Free to start
Publish the template on a free account — no credit card and no trial clock.
Results in real time
Charts, filters and export to Excel, SPSS or CSV — with no extra work.
How to use this survey
- 1
Take the template
Create a free account and copy the template into your project with one click.
- 2
Adapt the questions
Adjust wording, scales and logic to your context — as often as you like.
- 3
Invite respondents
Share it by link, QR code, email or embedded on your website.
- 4
Analyse the answers
A live dashboard with charts, filters and export into your analysis tool.
The questions in this template
- What is the most important reason for your cancellation?
- What exactly happened? Please describe it in your own words.
- What does the new provider do better, in your view?
- How satisfied were you with us overall?
- What would we have had to do differently for you to stay?
- How likely is it that you will come back to us later on?
- What would have to happen for you to come back to us?
- Despite your cancellation, how likely are you to recommend us to a friend or colleague?
- May we get back to you about your answers?
All 9 questions are fully editable.
Frequently asked questions
Is the “Cancellation Survey” template free?
Yes. You can use, customize and publish the template for free — a free account is all you need.
How do I use the “Cancellation Survey” template?
One click on “Use this template” creates it as your own survey in the editor. From there you can adapt it and share it by link, QR code, email or embedded on your own website.
Can I change, delete and add questions?
Completely. Once taken, the survey sits in your editor: every question, scale and answer option can be edited, reordered or removed.
What data does the “Cancellation Survey” template collect?
Which data you collect is decided question by question — if you don't ask for personal data, none is collected. Every question in the template can be changed or removed before you publish.
Are surveys built from the “Cancellation Survey” template secure and anonymous on empirio.ai?
Respondents need no account and simply open the link. Whether answers stay anonymous is up to the questions you ask: as long as nothing personal is asked, no answer can be traced back to a person.