Neb. Rev. Stat. § 44-918

A request for authorization and an authorization form may be delivered to a consumer or a customer as part of an opt out notice pursuant to section 44-909 if the request and the authorization form are clear and conspicuous. An authorization form is not required to be delivered to the consumer or customer or included in any other notices unless the licensee intends to disclose protected health information pursuant to subsection (1) of section 44-916 .