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Copyright Transfer and Conflict of Interest Statement - Springer

By Clifford Peterson,2014-02-08 03:59
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Copyright Transfer and Conflict of Interest Statement - Springerof,and

11 West 42nd Street, 15th Fl, New York, New York 10036

    212-431-4370 Fax 212-941-7842

    Neonatal Network: The Journal of Neonatal Nursing

    Copyright Transfer and Conflict of Interest Statement

Names of All Authors: Click here to enter text.

    Title of Manuscript: Click here to enter text.

    Date: Click here to enter a date.

Your Name: Click here to enter text.

    Credentials/Degrees: Click here to enter text.

    If RN, Nursing Degree(s): ? AD ? Diploma ? BSN ? Masters ? Doctorate

    Current Employer: Click here to enter text.

    Position/Title: Click here to enter text.

    Mailing Address: Click here to enter text.

    Phone Number: Click here to enter text.

    Email: Click here to enter text.

    Please describe expertise and years of training specific to the article listed above. Click here to enter text.

Each author must read, sign and return the following document. This form may be copied and distributed

    to individual authors. This form must be returned by either mail, fax, or by email to:

    Megan Larkin, Managing Editor

    Springer Publishing Company, LLC

    11 West 42nd Street, 15th Floor

    New York, New York 10036-8002

    Fax: 212-941-7842

    Email: mlarkin@springerpub.com

SUBMISSION CRITERIA

    PUBLISHER COPYRIGHT: Copyright of published text, figures, tables, or illustrations will be maintained by Springer Publishing Company, LLC, publisher of Neonatal Network: The Journal of Neonatal Nursing. For future use of the accepted manuscript in other works, authors must submit a written permission request (email, fax, letter) to the Managing Editor.

    AUTHORSHIP: All authors agree that each has participated in the study and/or preparation of the manuscript to a satisfactory degree deserving of authorship and that all authors have viewed the final version prior to submission of the manuscript to the publisher.

    ORIGINALITY: All authors agree that the article and supporting work is original and they are authorized to submit such material to the journal. As well, that the manuscript has not been published elsewhere and will not be submitted to another publisher without official response from the editors of the journal and that the manuscript will not be published, nor republished once accepted, without permission.

TRANSFER OF COPYRIGHT

    The undersigned author(s) transfers all copyright ownership of the above named article to Springer Publishing Company, LLC, in the event that the article is published in the Journal. This transfer of copyright includes, but is not limited to, the worldwide rights to any and all forms of publication now known or hereafter developed, including all forms of print and electronic media. The undersigned author(s) warrants and represents that the article is original, is not under consideration by another journal, has not been published previously, and contains no matter that is libelous, unlawful, or that infringes upon another copyright.

Signature: (electronic or handwritten) Click here to enter text.

    Date: Click here to enter a date.

CONFLICT OF INTEREST DISCLOSURE

    Each author must disclose relevant financial relationships or any potential bias with an entity with a commercial interest. An entity with a commercial interest is one that produces, markets, sells, or distributes health care goods or services consumed by or used on patients.

    Manuscripts submitted to the journal may be chosen by the editors for inclusion in the continuing education activities offered by the Academy of Neonatal Nursing. The journal therefore complies with Criterion 2 of the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation. ANCC considers financial relationships in any amount as relevant if they occurred in the last 12 months. Financial relationships of spouse, family member, or partner are also considered relevant.

Name: Click here to enter text.

    Is there an actual, potential or perceived conflict of interest for yourself or spouse/partner? ? No ? Yes

    If yes, please complete the table below for all actual, potential or perceived conflicts of interest.

    Check all Category Description

    that

    apply

    Salary Click here to enter text. ?

    Royalty Click here to enter text. ?

    Stock Click here to enter text. ?

    Speakers Bureau Click here to enter text. ?

    Consultant Click here to enter text. ?

    Other Click here to enter text. ?

Do you address “off label” use in your article? ? No ? Yes

    *“Off-label” use is using a product for a purpose other than that for which it was approved by the FDA+

If “yes,” how will you inform readers? Click here to enter text.

Signature: (electronic or handwritten) Click here to enter text.

FOR EDITORIAL OFFICE USE ONLY

    CONFLICT RESOLUTION

    Procedures used to resolve conflict of interest or potential bias if applicable for this activity: ? Not applicable since no conflict of interest.

    ? Removed individual, with conflict of interest, from participating in all parts of the educational activity. ? Revised the role of the individual with conflict of interest so that the relationship is no longer

    relevant to the educational activity.

    ? Not awarding contact hours for a portion or all of the educational activity.

    ? Undertaking review of the educational activity by a content reviewer to evaluate for potential bias,

    balance in presentation, evidence-based content or other indicators of integrity, and absence of bias,

    AND monitoring the educational activity to evaluate for commercial bias in the presentation. ? Undertaking review of the educational activity by a content reviewer to evaluate for potential bias,

    balance in presentation, evidence-based content or other indicators of integrity, and absence of bias,

    AND reviewing participant feedback to evaluate for commercial bias in the activity. ? OtherDescribe: Click here to enter text.

    Nurse Planner Signature

    An “X” in the box below serves as the electronic signature of the Nurse Planner reviewing the content of this Copyright Transfer and Conflict of Interest Statement.

    ? Electronic Signature (Required)

    Completed By: Click here to enter text. Date: Click here to enter a date.

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