Unsubscribing from your list should be simple: click a link, unsubscribed.
But if you really decide, for reasons that are probably not really good, to make it difficult for subscribers to unsubscribe, do you have a plan to use the additional information you are requesting? Are you going to extract insights from the answers you get? Is there a way for you to turn those into actions that will, for example, decrease the number of unsubscribes over time?
My guess is, the answer is no.
And so, why bother? Why adding additional steps to a simple process? Why leaving a bad taste in your subscribers’ mouth in the very moment they are signalling they are getting tired of you?
Nobody ever loved something more because they found it difficult to leave it.