Registration & Alternative Payment Mail-In Form

Please Complete and Submit the Provided Registration Form

Our team will be in contact with further instructions.

In addition, if you're planning to pay with a check, please print off and mail-in the order form linked below with your payment. 

Click to View the Mail-In Order Form

Conflict Check Form

In order for us to provide what we believe is a public service to Nebraska, we are required to review your interest to determine whether we have a conflict of interest or potential conflict of interest in granting you access to our platform. Thank you for your patience as we try to protect all guardians, conservators and other surrogate decision-makers.