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Change of Authorship Form

(Must be completed and signed by ALL authors)

Please check all that apply

_____New author(s) have been added (in addition to this form, all new authors must complete the copyright transfer agreement and conflict of interest disclosure.

_____Change in order of authorship.

_____An author wishes to remove his/her name. An author's name may only be removed his/her own request and a letter signed by the author should accompany this form

Manuscript Number_____________

Manuscript Title_______________________________________________________________________

Former Authorship

Please list ALL AUTHORS in the same order as the original submission. For more than 12, use an extra sheet.

Print Name		Print Name
Name (1)		Name (7)
Name (2)		Name (8)
Name (3)		Name (9)
Name (4)		Name (10)
Name (5)		Name (11)
Name (6)		Name (12)

New Authorship

All authors must sign below agreeing to the changes in authorship. The authorship order must reflect the authorship order of the manuscript.

Name (1)		Signature		Date
Name (2)		Signature		Date
Name (3)		Signature		Date
Name (4)		Signature		Date
Name (5)		Signature		Date
Name (6)		Signature		Date
Name (7)		Signature		Date
Name (8)		Signature		Date
Name (9)		Signature		Date
Name (10)		Signature		Date
Name (11)		Signature		Date
Name (12)		Signature		Date

Please print form and fax to 601-815-1675.