Customer churn survey template

Before you send it

Agree with the client what “stopped buying” means for their business. A cancelled subscription is different from a missed weekly order. Choose a clear period and use it consistently when selecting customers.

Replace [client name] throughout. Adjust the time ranges to the client’s buying cycle without changing them after responses arrive. Test the questions with a colleague. Keep answers optional and avoid asking for names, email addresses, or sensitive details.

1. Question 1

   Which best describes your relationship with [client name] today?

   Choose one: I stopped buying or using it; I buy or use it less; I still buy or use it regularly; Other.

   Setup note: If someone still buys regularly, thank them and end the survey. Keep those answers separate from churn responses.

2. Question 2

   When did you last buy from or use [client name]?

   Choose one: Within the last month; 1–3 months ago; 4–6 months ago; More than 6 months ago; I do not remember.

3. Question 3

   What were you hoping [client name] would help you do?

   Answer in your own words.

4. Question 4

   What was the main reason you stopped or reduced your use?

   Answer in your own words. If several things mattered, tell us which mattered most.

5. Question 5

   Was there a particular experience that influenced your decision?

   Tell us what happened, or write “No particular experience”. Please leave out names and personal details.

6. Question 6

   What do you use or do instead now?

   Answer in your own words. “Nothing instead” is also a useful answer.

7. Question 7

   What, if anything, could [client name] change to make it worth considering again?

   Answer in your own words. It is fine to say that nothing would change your decision.

8. Question 8

   Is there anything else you want [client name] to understand about your decision?

   Optional. Answer in your own words.

Share with the client’s own customers

Have the client send the survey through a channel their customers agreed to receive messages on. Do not buy a list or contact people who opted out. This template does not include respondents or send invitations.

Invite customers who meet the agreed churn definition, not just those expected to give positive feedback. Record the number invited, the selection rule, the sending dates, and the number who answered. A public social link can attract people outside that group; report those responses separately.

Explain any agency access to answers in the invitation. Do not promise anonymity if your tool records identifying information. Tell customers the closing date and thank them when they finish.

Report a small sample honestly

Read each answer before grouping similar reasons into themes. Count respondents, not repeated mentions from the same person. Separate the main reason from secondary issues. A response can mention several themes, so theme totals may exceed the response count.

Lead with counts and their denominator, rather than precise-looking percentages. State how many answered each question; skipped answers change the denominator. Include the invitation method, date range, and churn definition beside the findings.

A small, self-selected sample describes the people who replied, not all customers. People who ignored the survey may have different reasons. Even 10 responses do not establish certainty. Do not claim a margin of error or say one issue caused churn across the whole customer base.

Keep contradictory answers visible. Use real quotes only, reproduced verbatim with personal details removed, and check permission before client-facing sharing. Treat suggested fixes as ideas to test, not proof that customers will return.

In the client report, separate what respondents said, what you think it means, and what you recommend testing next. If replies are sparse, label the findings “Early feedback from respondents” and explain the limits before making recommendations.