First Name
Last Name
Email
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How long have you been at Chalkline?
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Why have you chosen to leave us? Please be as detailed and honest as possible
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How satisfied were you with your overall experience at Chalkline? Please tell us what worked or didn't work for you.
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What could we have done differently to avoid losing you?
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If your circumstances were to change, would you consider coming back to us?
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Would you come back
Yes, I'm sad to leave
It's possible
No, time for me to move on
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Would you refer your friends/family to Chalkline?
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Would you refer us
Yes
No
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If your answer was no, please tell us why so we can improve
Our Cancellation Policy requires either 4 Week or 30 Day notice depending on your billing cycle, as of what date would you like your membership to terminate?
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By marking 'Yes' below, I understand that submitting this form does not automatically cancel my membership. I acknowledge that a staff member will reach out to me to follow up, and that my requested cancellation date is subject to our cancelation policy terms (which are detailed on this page)
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Confirm understanding
Yes
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