Form · Membership

Membership cancellation form template

Makes leaving easy while still giving people a real alternative. After the reason, members are offered a pause or a cheaper plan once, with no pressure: a pause records the return date, a switch hands them to the team, and a cancellation collects the end date and optional feedback. Members who are moving away skip the offer entirely.

11 questions~3 min to answer2 branches3 endings
membership cancellation formcancel membership requestgym cancellationsubscription cancellationbranching
Use this template

Try it live

Try it as a respondent

Every question, and where it leads

The conversation

What a respondent is asked, in order.

Sorry to see you go. This takes about a minute, and the feedback questions at the end are optional.

1

Your name and the email on your membership

Contact info · required
2

Membership number, if you have it

Short text · optional
3

Which membership is this about?

Single select · required
4

What's the main reason?

Single select · requiredsplits the flow
5

We're sorry. What went wrong?

Long text · optionalif reason is I'm unhappy with the service
6

Would either of these work better than cancelling?

Single select · requiredsometimes askedsplits the flow
7

When would you like to come back?

Date · requiredif alternative is Pause my membership instead
8

When should the cancellation take effect?

Date · requiredsometimes asked
9

Overall, how was your time as a member?

Rating · optionalsometimes asked
10

Anything else you'd like us to know?

Long text · optionalsometimes asked
11

Can we let you know about offers if you'd like to return one day?

Yes / No · requiredsometimes asked

Endings

Cancellation request received

Your pause request is in ⏸️

Let's find a better fit

The flow

Where each answer leads. Every route here is editable once the form is yours.

A labelled route is taken only by answers matching the label

What this template uses

  • Contact info
  • Short text
  • Single select
  • Long text
  • Date
  • Rating
  • Yes / No
  • 9 branches
  • 3 endings

Questions to consider

  • Do you actually offer pauses and cheaper plans, and on what terms?
  • What notice period applies, and should the form mention it?
  • Who confirms a cancellation, and how quickly?
  • Is the reason question useful enough to keep required?

How to use the responses

Confirm every cancellation by email with the exact end date, and act on pauses and switches within a working day, since those members chose to stay. Count the reasons each month: a rise in "not using it enough" points to onboarding, and repeated complaints about service belong with the manager, not in a spreadsheet. Only contact people about coming back if they said yes.

How to customize and share it

  1. 1Change the membership options and the pause and switch offers to what you really provide, or remove the offer question if you don't have one.
  2. 2Add your notice period to the end date question so members aren't surprised.
  3. 3Link the form from your account page and cancellation emails, so members never have to phone to leave.

Frequently asked questions

Does submitting this form cancel the membership straight away?

No. It records the request. Your team confirms the cancellation and the end date, usually by email.

What should a membership cancellation form ask?

Who the member is, which membership, the reason, when it should end, and optional feedback. Keep the feedback optional so leaving stays easy.

Is it okay to offer a pause before someone cancels?

Yes, if you offer it once and make declining just as easy. This form asks one question and moves on whatever the answer.

Can I use this for subscriptions as well as clubs and gyms?

Yes. Rename the membership options to your plans and the rest of the form works the same way.

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Ask like a person. Watch them finish.