Authorship and Conflicts of Interest Statement Template
Title of the Manuscript

Authorship - Author/s listed below are responsible for the content which includes the study design, data gathering, data analysis, drafting and final approval.

	Author Name	Study design and conception	Data acquisition	Analysis and interpretation of data	Drafting	Final Approval
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Author/s listed below has no conflicts of interest and has no affiliations or involvement with any organization.
Author/s listed below has a conflicts of interest and has affiliation and involvement with an organization
By signing below, the authors agree that all information listed in this document is accurate and true.
Author Name
First Name Last Name
Author Signature
Clear
Date Signed
Month Day Year
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Author 2 Name
First Name Last Name
Author 2 Signature
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Date Signed
Month Day Year
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Author 3 Name
First Name Last Name
Author 3 Signature
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Date Signed
Month Day Year
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Author 4 Name
First Name Last Name
Author 4 Signature
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Date Signed
Month Day Year
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Author 5 Name
First Name Last Name
Author 5 Signature
Clear
Date Signed
Month Day Year
Date
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Authorship and Conflicts of Interest Statement Template