Author Disclosure Form

Article title:
Author’s name:
1.I created the first draft of this manuscript
  Yes No
 If no, please explain how the first draft was generated.
2.The research/study was supported by a corporate sponsor:
  Yes No
 If yes, answer questions 3-6.
3.I have received honoraria (personal compensation) from thesponsor of the study:
  Yes No
4.I have received grant support from the sponsor:
  Yes No
5.I have an equity or ownership interest in the sponsor:
  Yes No
6.I am an employee of the sponsor:
  Yes No
 

Checklist for authors

  1. Cover letter including:
    1. Title of the manuscript
    2. Intended classification of the manuscript (original research article, short report, etc.)
    3. List of all contents included in the packet
    4. Suggestions for specific peer reviewers (if any)
    5. Ethical approval by an institutional review board (if applicable)
    6. Disclosure of conflicts of interest (if applicable)
  2. Justification for more than 6 authors
  3. One hard copy of the manuscript, page numbered and stapled
  4. One correctly labeled disc or electronic copy of the manuscript
  5. Author Disclosure Forms
  6. On the first title page, all required information:
    1. Title
    2. Author names and affiliations
    3. Corresponding author’s contact information (including address, phone, fax, and e-mail address)
  7. On the second title page, title only
  8. Abstract (correct format and word limit)
  9. Text
  10. Tables and figures
  11. References checked for accuracy, style and numbering