TELİF HAKKI FORMU

.../..../20

MAKALE BAŞLIĞI:

.......................................................................................................................................................................

.........................................................................................................................................

Sayın Editör,

Yayınlanması dileğiyle Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi’ne gönderdiğimiz makalenin yazarları olarak;

Bu çalışmanın:

1. Bilimsel etik ve sorumluluğunun bize ait olduğunu,

2. Daha önce yurtiçinde veya yurtdışında Türkçe veya yabancı bir dilde yayınlanmadığını

3. Başka bir yayın organına yayınlanmak üzere gönderilmediğini

4. Yayın için kabulü halinde Creative Commons Attribution-NonCommercial-ShareAlike 4.0 (CC-BY-NC-SA) Ulusla- rarası Lisansı altında lisanslanacağını kabul ediyoruz

1. ..............................................................................................................

İmza: .................................................................................

Yazışma Adresi : ....................................................................................................................................................................

Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

2. ..............................................................................................................

İmza: .................................................................................

Yazışma Adresi : ....................................................................................................................................................................

Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

3. ..............................................................................................................

İmza: .................................................................................

Yazışma Adresi : ....................................................................................................................................................................

Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

4. ..............................................................................................................

İmza: .................................................................................

Yazışma Adresi : ....................................................................................................................................................................

Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

5. ..............................................................................................................

İmza: .................................................................................

Yazışma Adresi : ....................................................................................................................................................................

Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

6. ..............................................................................................................
İmza: .................................................................................
Yazışma Adresi : ....................................................................................................................................................................
Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

7. ..............................................................................................................
İmza: .................................................................................
Yazışma Adresi : ....................................................................................................................................................................
Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

8. ..............................................................................................................
İmza: .................................................................................
Yazışma Adresi : ....................................................................................................................................................................
Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

9. ..............................................................................................................
İmza: .................................................................................
Yazışma Adresi : ....................................................................................................................................................................
Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

10. ..............................................................................................................
İmza: .................................................................................
Yazışma Adresi : ....................................................................................................................................................................
Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

11. ..............................................................................................................
İmza: .................................................................................
Yazışma Adresi : ....................................................................................................................................................................
Tel: ........................................................................................... Faks : ................................................................................... e-posta : ........................................................................................................

12. ..............................................................................................................
İmza: .................................................................................
Yazışma Adresi : ....................................................................................................................................................................
Tel: ........................................................................................... Faks : ................................................................................... e-posta : .....................................................