Permission Form, Reprinting Illustrations

Dear xxxxxxx:

I am writing to request permission to reprint the illustration titled "xxxx." It appeared on page xx of (book or journal title), edited by xxxxx, in (year).This illustration is to appear as originally published [or with changes or deletions as noted] in "YOUR ARTICLE'S TITLE," by AUTHOR'S NAME, which the Johns Hopkins University Press is currently preparing for publication. This article is scheduled to be published in the MONTH, YEAR, issue of the Bulletin of the History of Medicine, in a press run of about 1,750 copies.I am requesting nonexclusive world rights to use this illustration in this journal in all languages and for all editions, in print and online, in all retrieval systems now or ever invented. Full acknowledgment will be given in the journal. Please sign below and return one copy of this letter to me to indicate your consent.If you don't hold the copyright to xxxx, or if I must seek permission from another source, please note the fact below. Should it be necessary for me to seek permission elsewhere, any information you could provide to help me contact the proper party would be greatly appreciated.Thank you for your consideration of this request.




The above request for permission to reprint is approved on the conditions specified below and on the understanding that full credit will be given to the source. The acknowledgment should read as follows:

Approved by:


Announcement from the Publisher

We have recently expanded the rights granted to contributors in our standard permissions agreement by allowing authors to include theirarticles in institutional depositories. Previously, the Press had restricted use to personal or departmental databases or on-line sites.

The change recognizes the important role institutions play in the scholarly communication process. It seems reasonable that the scholarship produced by faculty members should be made available to others within that same institution which, after all/ is providing either direct or indirect support.

The full text of the section that outlines author's rights is reproduced below. The new language is in point 4.

Rights of the Author: You have the following nonexclusive rights: (1) to use the Article in your own teaching activities; (2) to publish the Article, or permit its publication, as a part of any book you may write; (3) to include the Article in your own personal or departmental database or on-line site; (4) to include the article in your institutional database provided the database does not directly compete with either the Johns Hopkins University Press or Project Muse,is non-commercial, is institution-specific and not a repository that is discipline-based and/or accepts contributions from outside the institution. For use (4), you agree to request prior permission from the Press.

For all rights granted in this paragraph, you agree to credit the Press as publisher and copyright holder.