Cancellation of

Service Form

Date(Required)

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What was the reason for canceling our services? (Please select all that apply)(Required)

Dissatisfied with the cleaning quality

Found a cheaper cleaning service

Moving to a new home (out of service area)

Change in financial situation

No longer in need of cleaning services

Other

On a scale of 1 to 10, how satisfied were you with our services overall? (1 = Very Dissatisfied, 10 = Extremely Satisfied)(Required)

Did you communicate any concerns or issues to our team before canceling our services?(Required)

Did you experience any issues or problems with our service? If yes, please describe(Required)

Would you consider re-booking our services in the future? Why or why not?(Required)

Would You Prefer to Pause Service Instead?(Required)

Is there anything we could have done differently to retain your business?(Required)

What initially attracted you to Simplify Cleaning Services?(Required)

What specific improvements would have prevented you from canceling?(Required)

Would you be interested in a special offer to continue your service?(Required)