Banner Rehabilitation Hospital Contact Us Form

For further information about our medical rehabilitation services, billing or general inquiries, please provide us with the information listed below. 

Request Medical Records

Copies of medical records can be obtained by submitting a written request to our centralized Medical Records Department or by faxing a request to (623) 600-7007. For your convenience, a copy of the Patient Access and Authorization form (PDF) can be printed, signed and mailed to the address below. 

Medical Records Department 
Banner Rehabilitation Hospital West 
12740 N. Plaza Del Rio Boulevard 
Peoria, AZ 85381 

NOTE: In accordance with state law, a fee may be charged. 


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