AUSA Cancellation Form

AUSA Facility Online Cancellation Form

There is no fee if you return your tag and cancel in person at any AUSA facility. Please do so during our staffed hours to ensure our Front Desk staff can assist you.
Form Completion Date*

DayMonthYear
Members Home Facility*
Members Full Name?*

First NameLast Name
Please make sure you use the email address below that is associated with your account. If you are not sure, please ask our staff to check for you.
Members Email*
MUST be the email associated with your account.
Members Mobile*
Thanks. Would you mind sharing the reason for your cancellation?*

FinancialRelocationHealth ReasonsEnd of ContractLack of MotivationJoined Another FacilityInadequate Facilities or ServicesLack of TimeOther
How would you rate your overall experience?*

1

2

3

4

5

1 is Worst, 5 is Best
Did staff at the AUSA Facility provide a good experience?*

1

2

3

4

5

1 is Worst, 5 is Best
How did you find the presentation of the facility?*

1

2

3

4

5

1 is Worst, 5 is Best
Where did we fall short? Is there anything else you can share about your experience?
Will you be visiting the facility to return your tag or paying the $40 replacement tag fee?*

I will return my tag to the facilityPlease charge me the $40 fee
There is no fee if you return your tag and cancel in person at any AUSA Facility. Please do so during our staffed hours to ensure our Front Desk staff can assist you.

Access Tag Fee

$40.00AUD

Total

$0.00AUD

AUSA Facility Online Cancellation Form