ANNEX I
FORM FOR AUTHORS

This document, duly completed and signed, must accompany your manuscript. Your article cannot be accepted for consideration without it. Please read all the sections carefully and in the event of any doubt, read the instructions for the submission of articles to the Portuguese Journal of General Practice and Family Medicine (Rev Port Clin Geral 2010; 26:325-40). Each author must complete and sign a copy of this form.

The form should be sent by postal mail to:

Director da Revista Portuguesa de Medicina Geral e Familiar
Av. da República, 97-1º
1050-190 Lisboa

Identification
Authorship

I declare that:

Please give a brief description of your contribution to this work:

Conflict of interests

Please check to see if any of the conditions below applies to you:

If you have marked any of the preceding items or believe that there is any other potential conflict of interests, please compose a statement of conflict of interests to be published alongside the article:

If you do not feel that any potential conflict of interests exists with respect to this manuscript, mark below:

Assignment of rights

The authors will assign to the PJGPF the sole right to publish and distribute the content of the manuscript specified in this declaration via physical, electronic, broadcasting or any other medium that may come into existence. They also grant the PJGPF the right to use and exploit this manuscript, in particular by assigning, selling or licensing its content. This permission is permanent and takes effect from the moment the manuscript is submitted, has the maximum duration allowed by applicable Portuguese or international law and is of worldwide scope. The authors further declare that this assignment is made free of charge. If the PJGPF informs the authors that it is not going to publish their manuscript, the exclusive assignment of rights ceases forthwith.

The authors authorise the PJGPF (or any entity it may appoint) to act on their behalf when it believes that copyright may have been infringed.

The authors are entitled to:

The authors agree that, in the event of any dispute, the resolution of this agreement will be decided in Portugal in accordance with applicable Portuguese law.

Authorisation to publish

I declare that I hereby authorise publication of the attached article, entitled

of which I am an author. I further declare that this article is original and has not been published in any other form, nor has it been submitted simultaneously for publication in other journals or magazines. I declare, too, that I have read this form and that the information I have provided is complete and true. I also declare that I am the copyright holder and/or am entitled to use all the material contained in the manuscript (including illustrations), which rights I hereby assign to the Revista Portuguesa de Medicina Geral e Familiar in accordance with the terms set out in this document.

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Signature: ________________________________________