PLEASE FILL OUT THE COPYRIGHT TRANSFER AGREEMENT FORM BELOW AND FAX IT TO 313-577-9828.

COPYRIGHT TRANSFER AGREEMENT

The American Board of Family Medicine (the “ABFM”), publisher of The Journal of the American Board of Family Medicine (the “Journal”), will consider contributions for publication in the Journal only in accordance with the terms of this agreement and the undersigned author or co-authors (the “Author”) have submitted or wish to submit to the ABFM a contribution identified below (the “Work”) to be considered for publication in the Journal.

NOW, THEREFORE:

In order to induce the ABFM to consider the Work for publication in the Journal, the Author hereby irrevocably transfers to the ABFM the entire right, title and interest in the Work (and related material submitted to the ABFM – such as the Author’s reply to correspondence concerning the Work), including all rights under copyright, together with exclusive right and authority to claim copyright throughout the world in the Work. The ABFM hold such copyright fro the full duration of copyright and any renewals or extensions thereof.

Without in any way limiting the foregoing, the ABFM shall have the right to edit the Work, to reproduce and/or publish the Work in any medium which may now exist or be developed in the future, and to use the name and affiliations of the Author in connection with publication of the Work.

The Author agrees that permission for reprinting, distributing, or otherwise republishing the Work elsewhere must be obtained in writing from the ABFM.

The Author represents and warrants to be the sole author of the Work and the owner of all copyright to the Work and that the Work is original and does not infringe upon any copyright, proprietary of personal right of any third party; that the Work has not been previously published elsewhere; and that all statements and representations in the Work are true and accurate to the best of the Author’s knowledge.

This agreement is governed by the laws of the United States and the Commonwealth of Kentucky.

In the event that the ABFM decides not to publish the Work, the Author will be notified that the Work is not accepted for publication and all rights hereunder will revert to the Author.

In the event that the Work is a joint work, all co-authors must sign.

Please confirm your acceptance of the terms of this agreement by returning this agreement duly signed by the author or all co-authors.

Manuscript number:

Title of the Work:

Agreed to this date:

Signature:

Printed Name:

Address(Please Print Clearly):

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