When to send it
Every store has a natural rhythm. Coffee beans run out every few weeks, skincare every couple of months, clothing a few times a year. Work out the usual gap between a customer's orders, then send this survey to anyone who has gone about twice that long without buying. Too early and you nag people who were about to reorder; too late and they no longer remember why they stopped.
Don't send it to everyone who has ever bought once. One-off gift buyers and people who tried a sample were never regulars, and their answers will blur the picture. Start with customers who ordered at least twice and then went quiet.
Why these questions
The first page asks for the main reason they haven't ordered lately. The options cover the honest range: they didn't need anything, they found something they prefer, the price crept up, a problem with the last order, the product didn't suit them, or they simply forgot. Only one answer is allowed, which forces a choice and makes the results easy to count.
Two of those reasons get a follow-up. Anyone who had a problem with their last order is asked what went wrong, because an unresolved complaint is the easiest kind of churn to reverse. Anyone who switched is asked what they buy instead and why. Those answers are a free view of your competition from the people who chose it over you.
The second page asks what would make them order again, then how they'd like to hear from you, if at all. That last question matters more than it looks. A customer who says please don't contact me is telling you to take them off the list, and respecting that protects your sender reputation and your brand. Those customers see a short ending that acknowledges the request; everyone else sees a thank-you.
The coupon
This is the most generous reward in the D2C set: a unique 20% code that expires after 14 days. A lapsed customer needs a reason to act now, and a short window gives them one. Unique codes stop a large discount spreading to bargain sites. Every customer who finishes gets the code, including those who ask not to be contacted again, because it rewards the feedback, not a promise to return.
What to do with the answers
Count the reasons first. If forgot or didn't need anything leads, your problem is timing, and a refill reminder or a subscription offer might fix it. If you already run subscriptions, former subscribers have their own win-back survey. If price or a competitor leads, you have a positioning question to answer. If problems with orders lead, look at fulfilment before spending anything on win-back campaigns.
Remove every do-not-contact customer from your marketing list the same week. Then compare these reasons with what your loyal customers tell you in the repeat customer feedback survey: the gap between the two lists is where retention is won or lost.