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ISPOR RESEARCH DIGEST (web database of over 7000 research presentations) CONTRIBUTED RESEARCH PRESENTATION REQUEST AND RELEASE FORM

As owner of all copyrights to the content of your visual presentation, ISPOR requests your permission, as well as the permission of any co-authors, to display the PDF file of your Poster Presentation on the ISPOR web site, in accordance with the following terms:

Copyright Ownership: The Author, along with any co-authors, shall be the owner(s) of all copyrights to the content contained in the PDF file of the Poster Presentation indicated below. This copyright agreement will not pertain to any other individual presentation.

Copyright License: In order for ISPOR to electronically archive and display the PDF file, the Author, along with any co-authors, hereby grants ISPOR a perpetual license to display this PDF file on the ISPOR web site, currently found at www.ispor.org.

Representations and Warranties: Author hereby represents and warrants to ISPOR that: (i) Author is the owner or authorized licensee of all right, title and interest (including all copyrights and other intellectual property rights) in and to all content that appears in the PDF file; (ii) all content that appears in the PDF file is the Author’s original work and contains no libelous or unlawful statements, does not infringe on the rights or privacy of others or contains material or instructions that might cause harm or injury, (iii) Author’s execution and performance of this Agreement does not and shall not constitute a breach of, or otherwise violate, any written or verbal understanding or agreement between Author and any third party; and (iv) ISPOR’s use of the PDF file shall not infringe or violate the copyrights, or other intellectual property rights, of any third party.

Please indicate the Meeting/Congress where the contributed paper was presented:

__ ISPOR __  (3rd, 4th, 5th, 6th, 7th, 8th, 9th, 10th, 11th, 12th) International Meeting

__ ISPOR __  (1st, 2nd, 3rd, 4th, 5th, 6th, 7th, 8th, 9th, 10th) European Congress

__ ISPOR       ( 1st, 2nd) Asia-Pacific Conference

__ ISPOR       ( 1st) Latin-America Conference

Title of Presentation: ____________________________________________________________________________

Please indicate the Presentation Code:
Contributed Poster/Podium Presentation Code:  ___________________


I, ____________________________, the corresponding author of the above presentation, along with any co-authors, grant ISPOR license to display my PDF File on the ISPOR web site.

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Author (Please Sign)

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Date

PLEASE FAX COMPLETED AGREEMENT TO ISPOR -  FAX (USA): 1-609-219-0774


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