Opt Out/In

Due to the Coronavirus (COVID-19) outbreak, CyncHealth has paused processing opt-outs for the period Nebraska Executive Order 20-15 is in effect. Read this FAQ for more information.

Additionally, we urge those individuals who have opted out previously to rescind that decision at this time. To rescind your prior opt-out, please complete the form below.

Opt Out/In Form

Sharing Preference * Required
- Opt Into Sharing with NEHII
- Opt Out of Sharing with NEHII
Name * Required
First Last
Date of Birth - must be mm/dd/yyyy format * Required
Date Format: MM slash DD slash YYYY
Email * Required
Phone
Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country