Request for Permission to Republish

The copyright of all Wounds Canada resources is retained by Wounds Canada (Canadian Association of Wound Care). Users may download or print copies for their own, private use.

Users wishing to use reproduce or republish Wounds Canada material must seek prior approval for reproduction in any medium by completing this form.

Applicants for such permission should be aware that reproduction of Wounds Canada material must be verbatim, that is, unaltered, unless permission to revise material is given in writing.

Please note that should any additional forms, letters and/or provisions be required on behalf of Wounds Canada, an administration fee of $100.00 will apply.

The use of the Wounds Canada name or logo for the purposes of advertising or implied endorsement of any derived product or service is strictly prohibited.

All resources and materials provided by Wounds Canada are protected under copyright. Any unauthorized digitalization of these materials, in whole or in part, without the proper licensing agreements, is strictly prohibited and may result in legal action. Parties interested in utilizing these resources in any manner must seek and obtain appropriate licensing agreements with Wounds Canada. All rights reserved

This form has 7 sections. Please note that the information you provide isn't saved until you click Submit on the final page of the form.

Page 1 of 7

1. Applicant Information:

First Name(*)

Invalid Input

Last Name(*)

Invalid Input

Organization

Invalid Input

I am a...(*)

Clinician Patient Care Giver Other ...

Invalid Input

Please share your role with us

Invalid Input

Street Address(*)

Invalid Input

Country(*)

Invalid Input

Province(*)

Invalid Input

City(*)

Invalid Input

Postal/ZIP Code(*)

Invalid Input

Email Address(*)

Invalid Input

Phone Number(*)

Invalid Input

Phone Extension

Invalid Input

Page 2 of 7

2. Table, figure or selection to be reproduced (in totality):

You can request up to 5 items per request.

How many items will you be requesting?(*)

Invalid Input

Page 3 of 7

Item Request #1

Item to be reproduced(*)

Invalid Input

Author(s)(*)

Invalid Input

Publication title(*)

Invalid Input

Article title

Invalid Input

Volume

Invalid Input

Page Number(s)

Invalid Input

Year

Invalid Input

URL

Invalid Input

Will be identified in publication as figure/table (if appropriate)(*)

Invalid Input

Are you asking for permission to translate this material into another language? (*)

Invalid Input

If yes, specify language(*)

Invalid Input

Item Request #2

Item to be reproduced(*)

Invalid Input

Publication title(*)

Invalid Input

Author(s)(*)

Invalid Input

Article title

Invalid Input

Volume

Invalid Input

Page Number(s)

Invalid Input

Year

Invalid Input

URL

Invalid Input

Will be identified in publication as figure/table (if appropriate)(*)

Invalid Input

Are you asking for permission to translate this material into another language? (*)

Invalid Input

If yes, specify language(*)

Invalid Input

Item Request #3

Item to be reproduced(*)

Invalid Input

Publication title(*)

Invalid Input

Author(s)(*)

Invalid Input

Article title

Invalid Input

Volume

Invalid Input

Page Number(s)

Invalid Input

Year

Invalid Input

URL

Invalid Input

Will be identified in publication as figure/table (if appropriate)(*)

Invalid Input

Are you asking for permission to translate this material into another language? (*)

Invalid Input

If yes, specify language(*)

Invalid Input

Item Request #4

Item to be reproduced(*)

Invalid Input

Publication title(*)

Invalid Input

Author(s)(*)

Invalid Input

Article title

Invalid Input

Volume

Invalid Input

Page Number(s)

Invalid Input

Year

Invalid Input

URL

Invalid Input

Will be identified in publication as figure/table (if appropriate)(*)

Invalid Input

Are you asking for permission to translate this material into another language? (*)

Invalid Input

If yes, specify language(*)

Invalid Input

Item Request #5

Item to be reproduced(*)

Invalid Input

Publication title(*)

Invalid Input

Author(s)(*)

Invalid Input

Article title

Invalid Input

Volume

Invalid Input

Page Number(s)

Invalid Input

Year

Invalid Input

URL

Invalid Input

Will be identified in publication as figure/table (if appropriate)(*)

Invalid Input

Are you asking for permission to translate this material into another language? (*)

Invalid Input

If yes, specify language(*)

Invalid Input

Page 4 of 7

Please indicate all intended uses of the material:

Select all that apply:(*)

Educational material for internal policy or training materials
Educational material for use by a for-profit individual or agency
Educational material for use by a not-for-profit agency
Educational material for free distribution by for-profit individual/group
Component of a saleable product
Publication in a book chapter, manuscript, educational resource, other edition in preparation and in all future editions, print or electronic
For use in an electronic medical record keeping system
For incorporation in an electronic clinical tool in a health care setting
Other

Invalid Input

Please provide more details about "Other" usage:

Invalid Input

Page 6 of 7

In what medium will you reproduce this material (print or electronic)? How many copies of this material do you intend to make? (if unknown, please estimate).(*)

Invalid Input

What is the title of the medium?(*)

Invalid Input

If digital, please specify the URL:

Invalid Input

Who is the intended audience for this material?(*)

Invalid Input

Are you are seeking permission to republish the material(s) within a larger document/publication?(*)

No Yes

Invalid Input

Please provide the details of that document /publication:

Author(s)(*)

Invalid Input

Title(*)

Invalid Input

Publisher(*)

Invalid Input

When do you plan to publish/distribute this material?(*)

Invalid Input

Please provide any additional information relevant to your request here

Invalid Input

Page 7 of 7

Legal Agreement for Use of this Wounds Canada Material

By providing your digital signature below, you are agreeing to the following:

I/we acknowledge and agree that the Wounds Canada (Canadian Association of Wound Care) resources identified in this republication request may be used solely by the applicant, in their original and unaltered form, and only for the specific purpose, context, format, audience, and period expressly approved in writing by Wounds Canada.

Unless prior express written permission is obtained from Wounds Canada, the Licensed Materials shall not be adapted, edited, abridged, modified, transformed, reformatted, digitized, or converted into any other format or medium, including, without limitation, by incorporating or embedding them in an electronic medical record or electronic health record system (EMR/EHR), software program, mobile application, website, digital platform, clinical decision-support system, database, commercial product, interactive tool, algorithm, workflow, assessment instrument, or educational module.

The Licensed Materials shall not be entered, uploaded, embedded, processed, or otherwise used, in whole or in part, as an artificial intelligence prompt or as input for the training, fine-tuning, testing, validation, retrieval, operation, or development of any artificial intelligence or machine-learning system, model, application, tool, or output without Wounds Canada’s prior express written permission.

You may not use The Licensed Materials, or any derivative works created from them, for any commercial purpose. This includes, but is not limited to, selling, licensing, renting, or using the materials in any way that generates revenue or commercial advantage.

Any publication, reproduction, display, or distribution authorized by Wounds Canada must identify the applicable Wounds Canada resource by its complete and correct title and prominently include the statement, “Used with permission of Wounds Canada.” All copyright and other intellectual property rights in and to the Licensed Materials remain the exclusive property of Wounds Canada or the applicable rights holder, and no ownership interest, licence, or other right is granted except for the limited permission expressly provided in writing by Wounds Canada. Such permission is personal to the applicant and is non-exclusive, non-transferable, non-assignable, and non-sublicensable and may not be relied upon by, shared with, or transferred to any other person or entity or extended to any purpose, publication, edition, language, territory, format, medium, platform, product, or distribution channel not expressly identified in the request and approved in writing by Wounds Canada.

Any use outside the approved scope requires a separate request and Wounds Canada’s prior express written authorization. Wounds Canada reserves the right to revoke its permission if the Licensed Materials are used in breach of these terms.

You can use your touch screen or mouse to sign below:

Sign Below(*)

Sign Above

You must complete this field

Wounds Canada has permission to contact you(*)

Yes No

Invalid Input

Wounds Canada takes your privacy seriously. I agree that Wounds Canada and its authorized third parties will use the information you provided in accordance with our Privacy Policy to send you communications which may include promotions, product information, and service offers. (*)

Agree Disagree

Invalid Input

AntiSpam

Invalid Input

{{{_source.title}}} {{#_source.showPrice}} {{{_source.displayPrice}}} {{/_source.showPrice}}

Publications

Request for Permission to Republish

Item Request #1

Item Request #2

Item Request #3

Item Request #4

Item Request #5

{{{_source.title}}} {{#_source.showPrice}} {{{_source.displayPrice}}} {{/_source.showPrice}}

Publications

Request for Permission to Republish

Item Request #1

Item Request #2

Item Request #3

Item Request #4

Item Request #5

Sign in to your account