Full Name
Email
Main Reason for termination
Dissatisfaction with results
Changes within the company
Found a provider with better cost-benefit
Decided to manage campaigns internally
Closing Down the Business / Moving to a new opportunity
Why Leaving Now?
What went wrong through our Partnership?
Rate Your Experience
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Ad Performance
Lead Quality
Coaching / Training
Communication
Use a scale of 1-10 to rate your experience with us on each of these areas
What did you like about us? (Patients you got, Efficiency, Support)
Is there anything that was missing from our partnership that you would have wanted to see?
What is the deciding factor that is making you leave?
If we could work for free and solve this, would you be willing to continue with us?
Yes
No
Would you recommend us to other Companies?
Yes
No
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