I am looking to cancel:
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Just my PT agreement - I'd like to keep coming with just my membership
Just my Nutrition & Wellness Coaching agreement
Everything with 5EW
Other
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List is empty.
Other (please specify)
First Name
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Last Name
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Email
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Requested date of Cancellation
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All cancellations are applied on the 14th day from this submission. However, if you’d prefer a date after this please select from the below.
Reason for Cancellation
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I'm moving away
My financial circumstances have changed
I wasn't using the facility enough
It was too expensive
I have issues with the facility
I have issues with customer service
I have a personal circumstance not listed above
Other
No elements found. Consider changing the search query.
List is empty.
Other (please specify)
On a scale of 1 to 10, how likely would you recommend 5th Element Wellness to someone else?
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Bad
Good
What would it take to keep you as a member? (no promises, we just don’t want to die without knowing the truth)
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Would you like to continue working with your Coach through our App?
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Yes
No
Other comments
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