Manuscript Submission Cover Letter printable pdf download

Manuscript Submission Cover Letter

Title of manuscript:

Name of each author:

Brief description of role of each author in development of manuscript:

Name of contact author with contact information (mailing address, phone number, email address)

Has each author completed the ICMJE

Disclosure of Conflicts of Interest

form?

Yes ____ No____

Is there any identifying information regarding a patient or other person in the manuscript?

Yes ____ No ____

If yes, provide a copy of the informed consent from the individual to use this information. The

individual must be shown the manuscript to be published. Indication of informed consent must

be included in the manuscript.

Is this manuscript reporting on research conducted on human or animal subjects?

Yes ____ No ____

If yes, have all components of Protection of Research Participants in

been followed?

Yes ____ No ____ This is not a research report manuscript ____

If applicable, indication of Institutional Review Board approval must also be included in the

manuscript.

Manuscript Submission Cover Letter