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Two column split pairing a pitch with three numbered steps and a phone line beside a form card collecting name, phone, topic, and preferred time.
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Callback Request Form turns a support call into an appointment the visitor sets. The left column pitches the idea with a heading, a short paragraph, and three numbered steps covering pick a window, we confirm by email, and the right person calls, closed by a direct phone line under a hairline for anyone who would rather dial. The right column is a bordered form card collecting name, phone, call topic, and a preferred time window as selectable radio rows.
The steps and the time windows are each a typed array, so retitling a step or adding a fourth slot is a single edit. The form is built from the ui Label, Input, NativeSelect, and RadioGroup primitives with a full width submit, so wiring it to a scheduler or a callback queue is the only integration work, and the helper lines under the phone field and the windows set expectations without adding fields.
Reach for this block on a contact or support page when a scheduled callback beats a live queue, which is most of the time for a considered purchase. It suits a sales led product where prospects want a real conversation but not an open ended hold, and it suits support teams that would rather batch calls into named windows than staff a phone line all day. The pitch does the persuading; the form just captures the slot.
A natural flow around it on a Marketing Pro page:
Before
After
The obvious fit is a sales or support callback booked into a time window. A few other ways to use the frame:
Tip: only offer windows you can actually staff, and confirm by email fast. A booked slot that goes unanswered costs more trust than never offering the callback at all.