Authorship
I declare that:
I have contributed substantially to the conception and design, acquisition of data, or analysis and interpretation of data.
I have participated in drafting the article or its critical revision for intellectually important content.
I have revised the final version of the manuscript and approved it for publication.
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:
I have received a financial incentive in the last 5 years from an organisation which may in some way gain or lose financially from the results or conclusions of the manuscript.
I have been employed in the last 5 years by an organisation which may in some way gain or lose financially from the results or conclusions of the manuscript.
I have some kind of financial stake in an organisation that may in some gain or lose financially from the results or conclusions of this manuscript.
There are other financial interests to be declared.
My academic institution or employer has an interest or financial conflict related to the results or conclusions of the manuscript.
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:
I hereby declare that I am not affected by any conflict of interests whatsoever.
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:
Make a reasonable number of copies of their work in physical or digital medium for their personal and professional use and for teaching purposes, but not for any commercial purpose (including sale of the right of access to the article).
Place an exact copy in electronic format of the article published by the PJGPF on their website or that of their institution provided that due reference is made to its publication in the PJGPF and its content (including symbols identifying the PJGPF) has not been altered.
Publish in a book of which they are the authors or editors the content of the manuscript in full or in part, provided there is due reference to its publication in the PJGPF.
• Receive, for five years after publication, 10% of the amount paid to the PJGPF by third parties for offprints of their article, if this amount exceeds EUR 1500.
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.
I declare that I have read and agree to the conditions set forth above.
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.
Place:
Date:
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Signature: ________________________________________