This document, duly completed and signed, must accompany your manuscript. Your article cannot be accepted for consideration without it. Please read all the sections carefully and in the event of any doubt, read the instructions for the submission of articles to the Portuguese Journal of General Practice and Family Medicine (Rev Port Clin Geral 2010;26:325-40). This form only has to be completed by the author handling the correspondence with the journal.

The form should be sent by postal mail to:

Director da Revista Portuguesa de Medicina Geral e Familiar
Av. da Rep├║blica, 97-1┬║
1050-190 Lisboa

Other contributions

Declaro que:

All the individuals or entities that have made important contributions to the work reported in the manuscript (including writing it), but which have not been specified as authors are named in the Acknowledgments section. Each of them has given written permission (per the form in Annex 3), which is attached to this form.
The manuscript does not include an Acknowledgments section because the authors have not received any meaningful contributions from other individuals or entities.
The work reported in this manuscript has not received any kind of external funding (including research scholarships).
This work was wholly or partially funded by individuals or entities which are not the author(s). Please describe the funding (use a separate sheet if necessary):

Place: Date: / /


Signature: ________________________________________