Network Exit Feedback Survey
Please help us improve by sharing your feedback about your experience and reasons for leaving the network.
Full Name (optional)
First Name
Last Name
Email Address (optional)
example@example.com
What was your primary reason for leaving the network?
*
Personal reasons
Professional change
Dissatisfaction with network
Lack of value/benefit
Other (please specify)
How long were you a member of the network?
*
Please Select
Less than 6 months
6 months to 1 year
1-2 years
More than 2 years
Please rate your satisfaction with the following aspects of the network:
*
Rows
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Communication
1
2
3
4
5
Events/Activities
6
7
8
9
10
Support from network staff
11
12
13
14
15
Opportunities for involvement
16
17
18
19
20
Networking with peers
21
22
23
24
25
Overall, how would you rate your experience with the network?
*
1
2
3
4
5
How likely are you to recommend this network to others?
*
Not at all likely
1
2
3
4
5
6
7
8
9
Extremely likely
10
1 is Not at all likely, 10 is Extremely likely
What did you value most about your time in the network?
What could we have done to improve your experience?
Would you consider rejoining the network in the future?
*
Yes
No
Maybe
Please share any additional comments or suggestions.
Submit Feedback
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