Welcome to the NE PDMP User Access Request and Training Acknowledgement Form.
Before beginning the registration process please be prepared with the following:
  •  Professional license number
  • Unique email address (you enter this in question #11)
  • Out of state attestation form (for non-Nebraska license holders only)
  • Copy of state professional license, wallet card, or diploma (for non-Nebraska license holders only)
 
If you have additional questions regarding this form or the registration process please refer to the PDMP User Access and Training Acknowledgement Form Instructions.
 
 
If you are having issues accessing your Nebraska PDMP account; do not submit a new request for access; instead please contact support at SUPPORT@NEHII.ORG or 402-506-9900 option 1.

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* 1. First Name

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* 2. Last Name

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* 3. Professional License Number

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