1) The problem → I want to know why my customers are opting into a free trial.
2) Why is this important → These insights will help me improve my offering, marketing, and positioning.
3) What's your plan B → Create a custom "page after signup" which asks these questions via a form. Or trigger a message via chat when someone starts a new trial.
4) Possible solutions we could build for you → Something like the attachment, but maybe after they begin the trial to reduce friction. Filling out the form could also be framed in a way to offer or appear to offer some benefit.