DECLARATION FOR AUTHORS

Author/s name and surname …………………………………………………………………………………………………………………………..
Affiliation  ………………………………………………………………………………………………………………………………………………………..
Title of the manuscript: ……………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………….

1.	Neither this manuscript nor one with substantially similar content under my/our authorship has been published or submitted for publication elsewhere. In case of selecting the submitted material for publication, the undersigned author(s) transmit the copyright to the Publishers of the journal to the Medical University of Lublin, the Publisher of Polish Journal of Public Health.
2.	I declare that there is no conflict of interests, which could have influenced impartiality and reliability of the paper.
3.	This study was supported by funds ……………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………
(research grants, research projects/ institutions)
4.	The study was approved by the local  Bioethical Committee (License no.)  at ……………………………………………… 
(in case of experimental research involving humans or animals)
5.	Declaration on the contribution of individual authors in the preparation of the article.
The declaration must be signed by all authors, and sent together with copyright statement and the manuscript to the editorial address.
Please enter the names and initials of the author in accordance with his/her participation in the preparation of the manuscript. If any of the points does not apply - please write "not applicable"(NA)	Author 1	Author 2	Author 3	Autohr 4	Author 5	Author …	
1. Development of the concept and methodology of the study							
2. Query - a review and analysis of the literature							
3. Submission of the application to the appropriate Bioethics Committee							
4. Collection of research material							
5. Analysis of the research material							
6. Preparation of draft version of manuscript							
7. Critical analysis of manuscript draft version							
8. Statistical analysis of the research material							
9. Interpretation of the performed statistical analysis							
10. Obtaining financial support for research and development							
11. Technical preparation of manuscript in accordance with the journal regulations							
12. Supervision of the research and preparation of the manuscript							
13. Other ……………………………………..							

Date: 
	Signature