ANNEX IV
STATEMENT OF ETHICAL CONDUCT FORM

If this is an original study, this document must accompany your manuscript. Your article cannot be accepted for consideration without it. In the event of any doubt, read the instructions for the submission of articles to the Portuguese Journal of General Practice and Family (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

Identification
Statement of ethical conduct

I declare that:
This study was carried out in accordance with the principles established in the Helsinki Declaration.
] The protocol of this study was sent to the Ethics Committee for consideration, and it was approved. A photocopy of the Committee's report is attached hereto.

If the study protocol was not submitted for consideration by an independent ethics committee, explain why this was not done and compose a statement of assurance that the ethical standards related to the research were complied with and, if applicable, attach a copy of the information given to the patient and the consent form. Please attach these documents to this form.

Place: Date: / /

 

Signature: ________________________________________