Understand Why Subscribers Cancel & Improve

Gather honest cancellation reasons and improvement suggestions from departing subscribers with this easy-to-use feedback form template.

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Espresso theme

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Subscription Cancellation Reason & Feedback Survey

Your Name

· · ·

Email Address

· · ·

Subscription Plan / Account ID

· · ·

Submit

The Subscription Cancellation Reason & Feedback Survey is designed to help businesses understand why customers choose to cancel their subscriptions. By capturing structured feedback at the point of cancellation, you gain invaluable insights into pain points, unmet expectations, and areas where your service can improve to reduce future churn.

This template is ideal for SaaS companies, streaming services, membership platforms, and any subscription-based business that wants to turn cancellations into learning opportunities. It covers key areas including primary cancellation reasons, satisfaction ratings, support experience, value-for-money perception, and the likelihood of resubscribing in the future.

With a clean, empathetic design, this form helps you collect actionable data without alienating departing customers — and even opens the door to win-backs. Start using this free template today to make every cancellation a chance to strengthen your product and retain more subscribers long-term.

3 Pages

17 Questions

~6min To complete

Free No credit card needed

Field types Single Choice ×3 Long Text ×3 Full Name Email Short Text Date Dropdown Multiple Choice Likert Scale Yes / No NPS Score Star Rating singlecheckbox

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Your Subscription Details 5 questions

Subscription Cancellation Feedback

We're sorry to see you go. Your feedback helps us improve our service for everyone. Please take a moment to share your experience.

1 Your Name * Full Name

2 Email Address * Email

3 Subscription Plan / Account ID Short Text

4 Subscription Start Date Date

5 How long have you been subscribed? * Dropdown

Page 2 Cancellation Reasons 6 questions

Why Are You Cancelling?

1 What is the primary reason for cancelling your subscription? * Single Choice

2 Please tell us more about your reason for cancelling Long Text

3 Which aspects of our service were you least satisfied with? Multiple Choice

4 How would you rate the overall value for money of your subscription? * Likert Scale

5 Did you contact our support team before deciding to cancel? * Yes / No

6 If you contacted support, was your issue resolved? Single Choice

Page 3 Final Thoughts 6 questions

Help Us Improve

1 How likely are you to recommend our service to others despite cancelling? * NPS Score

2 How would you rate your overall experience with us? * Star Rating

3 Would you consider resubscribing in the future? * Single Choice

4 What could we have done differently to keep you as a subscriber? Long Text

5 Any additional comments or suggestions for us? Long Text

6 I consent to being contacted about my feedback for follow-up purposes singlecheckbox

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.