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Request appointment

We will call you to schedule an appointment. Tell us the best time to reach you and what type of therapy you need.

Select a callback time.
Select the best time for us to call you back within 48 hours (weekdays only).
Select a therapy type.
This may be found on your order or enter your own.

Patient details

To receive a call back from Banner Physical Therapy, please provide the patient's information and contact details.

Please provide valid first name.
Please provide valid last name.
Please provide a valid phone number.
Please provide valid email address.
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Appointment request submitted

We will make every effort to contact you as soon as possible, during your preferred callback time. Please allow up to 48 hours during peak times.

We will collect patient insurance information on the call.

Request summary
Airway & Burbank
2120 Airway Ave Kingman, AZ 86409
Open now: 7am-6pm
(928) 757-1211

Preferred callback time

Therapy type

More than one therapy type needed

Patient details