1 Start 2 Complete *Required fields To proceed with your request, please complete the following requirements. See our privacy policy to learn how The Journal of Rheumatology collects, keeps, and processes your private information.: Questionnaire article details: Title: * Author(s): * Year published: * *Pre-2008: For questionnaires published prior to 2008, author permission must be supplied with your order. We will only be able to proceed upon receipt of the author permission. Please upload the author permission after Contact Information below. Volume number: * Issue number: * Page number(s): * Questionnaire name: * Format (select all that apply): * Print Electronic Audio Purposes of use: * Clinical Trial (if available, provide registration number below) Other (please provide details below) Details for purpose of use: * Distribution: * - Select -WorldwideUnited StatesCanadaUnited States and CanadaOther territories and/or countries (provide details below) Distribution details: Total number of administrations (number of patients multiplied by number of uses per patient): * Study start date: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044 Study end date: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044 Will you be translating the material? * Yes No If yes, what language(s) do you require? *For any translation(s) that may be required, permission must be obtained through The Journal of Rheumatology Publishing Co. Ltd. before translation. Translations should be performed by professional translators accredited for medical-technical translation in the respective source and target language(s). Linguistic validation is required for all translations of clinical outcome assessments (e.g., patient-reported outcomes, clinician reports) and questionnaires. Is this supported by commercial or pharmaceutical funding? * Yes No If yes, please name: Any modifications? * Yes No *If yes, written author permission for alterations/modifications to the requested content must be supplied with your order. Please upload the author permission after Contact Information below. Contact Information Requester name: * Organization: Email * Additional comments/information: Author Permission Please upload the author permission for alterations/modifications and articles published prior to 2008: Files must be less than 2 MB.Allowed file types: pdf. Terms and Conditions 1. New permission is required for additional patient administrations and study extensions. If required, submit a new request with the increased administrations/duration details. 2. Review copies of questionnaires are supplied for internal review purposes only, and cannot be administered to patients without obtaining permission from The Journal of Rheumatology Publishing Co. Ltd. 3. Printing any of our articles is not allowed without written permission from us before printing; permission must be obtained through The Journal of Rheumatology Publishing Co. Ltd. 4. The permission we issue is for the material that was published in The Journal of Rheumatology. Should you wish a modification in its reuse, send your intended modification to the first author to seek their permission, then provide us with a copy of the author’s approval for the modification. 5. Quotes are valid for 30 days and shall be paid in U.S. Dollars. Permissions prices are subject to change without notice. 6. Once your request is processed and permission is granted, the order may not be canceled.
