Survey

Patient feedback is important to us -- it helps us determine how to improve our services to provide the best care possible for our patients. To help us with this, we’ve created a brief, easy to complete survey that will provide us with information about how your visit went and how we can make it better next time. Whether you live in Burbank, Glendale or Studio City, a dentist visit should be pleasant and not nerve-wracking.

After you’ve visited the dentist in Burbank, we would appreciate it if you could complete this brief survey. Please let us know about your visit and the type of experience that you had. From a Zoom teeth bleaching to porcelain crowns and caps, we want to make your dental experience as non-intrusive and enjoyable as possible no matter what type of procedure you had performed.

Any comments you choose to make are kept strictly confidential and can only help us become better in the future. Please let us know what your experience with Dr. Gulesserian was like, whether you had a complete smile makeover or consulted with him about White Light teeth whitening.

Patient name

E-mail address

How would you rate your overall visit?
Excellent Very Good Average Not so good

When your appointment was over did you have a good understanding of your dental situation?
Yes Not really I wish I knew more about my situation

Were your financial options explained to you?
Yes No I already understand my financial options

Did you have to wait over 15 minutes past your appointment time to be seated? If so how long?
No 15 to 30 minutes 30 to 45 minutes Over 45 minutes

Did the staff greet you properly?
Yes Not really I don't recall

Would you refer your friends and family to us for treatments such as dental teeth bleaching?
Yes No I'm not sure

Please comment on how we could make your visit better, new services you would like to see, or other ways we can make you feel more comfortable.