Faculty of Medicine, Mazandaran University of Medical Sciences

RMM office, Faculty of Medicine, Mazandaran University of Medical Sciences, Km 18 Khazarabad road, Khazar Sq, Sari, Iran s P.O.Box: 4847191971, Telefax: (+98)-11-33543614

COPYRIGHT ASSIGNMENT

Manuscript NO:

Title:

All Authors’ Full Name (typed):

All authors ask to assign the copyright form and send it back by fax (+98-1133543614) or through e- mail ([email protected], [email protected] ).

Accordingly, author (s) agree to the following terms of publication:

1-Certify that we have participated sufficiently in the intellectual content, conception and design of this work or the analysis and interpretation of the data, as well as the writing of the manuscript, to take public responsibility for it and have agreed to have our name listed as a contributor.

2- Statement that the manuscript is not simultaneously being considered by other journals.

3- Statement that the manuscript contains valid data and has no redundant publication, plagiarism, data fabrication or falsification.

4- Statement that financial interests, direct or indirect, that exist or may be perceived to exist for individual contributors in connection with the content of this paper have been disclosed in the cover letter. Sources of outside support of the project are named in the cover letter.

5- Statement that the experiments were done in compliance with the laws regarding the use of animals and human subjects.

6- Statement that there are no grammars, syntax, spelling, punctuation or logic errors.

7- Statement that all the references which are numbered in the order they appear in the text, were used originally.

8- Statement that all persons who have made substantial contributions to the work reported in the manuscript, but who are not contributors, are named in the Acknowledgment and have given me/us their written permission to be named.

9- We give the rights to the corresponding author to make necessary changes as per the request of the journal, do the rest of the correspondence on our behalf and he/she will act as the guarantor for the manuscript on our behalf. RMM office, Faculty of Medicine, Mazandaran University of Medical Sciences, Km 18 Khazarabad road, Khazar Sq, Sari, Iran s P.O.Box: 4847191971, Telefax: (+98)-11-33543614

All authors’ signatures (All names must be signed by each author in his/her own handwriting in the order they appear in the body text)

1 Signature： Name: Date: 2 Signature： Name: Date: 3 Signature： Name: Date: 4 Signature： Name: Date: 5 Signature： Name: Date: 6 Signature： Name: Date: 7 Signature： Name: Date: 8 Signature： Name: Date: 9 Signature： Name: Date: 10 Signature： Name: Date: