Lost Customer Survey Template

This survey template is designed to collect feedback from lost customers to understand why they discontinued their use of your products or services.

The survey is split into three sections, including demographic information, reasons for discontinuing, and feedback and suggestions.

It covers topics such as customer satisfaction, likelihood of considering you again in the future, and open-ended questions for additional comments.

This survey template provides an opportunity for your customers to share their experiences and suggestions to help you improve your products and services and enhance the customer experience.

Number of Questions
7
Time to complete:
2 minutes
Categories:

Lost customer survey questions in this example

1. How long have you been a customer of our company?

The answer should be a single choice:

  1. Less than 6 months
  2. 6 months to 1 year
  3. 1 to 2 years
  4. More than 2 years

2. How did you first hear about our company?

The answer should be a single choice:

  1. Referral from a friend or family member
  2. Online search
  3. Advertising

3. What was the primary reason for discontinuing your use of our products or services?

The answer should be a single choice:

  1. Poor product quality
  2. High cost
  3. Better alternatives available
  4. Poor customer service

4. How satisfied were you with the products or services you received from our company?

The answer should be a single choice:

  1. Extremely satisfied
  2. Somewhat satisfied
  3. Neither satisfied nor dissatisfied
  4. Somewhat dissatisfied
  5. Extremely dissatisfied

5. How likely are you to consider using our products or services again in the future?

The answer should be a single choice:

  1. Extremely likely
  2. Somewhat likely
  3. Neither likely nor unlikely
  4. Somewhat unlikely
  5. Extremely unlikely

6. Is there anything you would like us to know about your experience as a customer of our company?

The answer should be a multi line text input.

7. Are there any changes or improvements you would suggest to enhance the customer experience with our company?

The answer should be a multi line text input.

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If you would like more information then please get in touch.