Gym Membership Cancellation Request

Records a gym member's request to end their membership while gathering their reasons and opinion of the service. Staff can then log dates, outstanding balances and any retention offers made.

Use this template

In the Claude connectors directory

Date

Name

First Name

Last Name

Phone number

What is the main reason for cancelling?

How often do you use the gym?

On a scale of 1 to 5, how would you rate your overall experience at the gym?

What health goals did you have when you joined?

Did you reach those goals?

Yes Partially No

How would reaching those goals have changed your life today?

If you could set the price, what would you pay for a membership here?

Which services did you use at the gym?

Cardio area Weights Group classes Personal training Fitness consultation Locker rooms

If you had a fitness consultation, did it meet your expectations?

Did staff provide good customer service?

Did you find the staff knowledgeable?

Did you find the gym clean?

How can we improve our service?

Give us another chance with no obligation to stay; your cancellation will still be processed as requested.

I'd like a free consultation I'd like a session with a trainer No, thank you

Member confirmation

Name

First Name

Last Name

Signature

Sign here

Cancellation date

Outstanding balance (30 days after cancellation)

Membership end date

Last visit date

Consultation offered?

Yes Offered and declined

Options offered

Active agreement in place

Yes No

Additional notes

Gym representative

First Name

Last Name

Related templates

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