Authorship declaration form
This form must be submitted for each work submitted to a WikiJournal. It should take no more than five minutes to complete. If you are unsure how to proceed at any point, please email

Email address *
Authorship declaration
If there are multiple authors, the 'corresponding author' should fill in this form.
Author name *
Your answer
Author institution
Affiliation (if applicable), such as university or hospital
Your answer
Article title *
Your answer
Wikipedia/Wikiversity user name *
The corresponding author must have created a Wikipedia/wikiversity/metawiki account
Your answer
Preferred journal
Choose the journal that fits the scope of the article best.
Article submission *
It is preferred that articles are submitted as publicly visible pre-prints at, however works can also be submitted confidentially by email to
Number of authors *
If the work has one author, they are automatically the 'corresponding author'. If there are more than one authors, the person filling in this form should be the corresponding author.
Co-author details
List co-author names and affiliations, with each co-author on a new line. Leave blank if sole author. If you use text from a Wikipedia article by multiple authors, write the title of that article.
Your answer
Name *
It is recommended to have your name displayed online with the article during peer review, but you may opt to be anonymous during peer review (double-blind review) with your name and reviewer names only being added upon publication.
Email *
In most cases, the email address of the corresponding author is published in the article. If requested the corresponding author can instead be contacted via a web form. Privacy settings can be edited in "User preferences" (, so that the email is hidden from the public.
License declaration
If the submission includes content from Wikipedia, it should have the same license, which is the Creative Commons Attribution-Share alike 3.0 Unported license (CC-BY-SA 3.0).

For submissions which are the own work of authors, the recommended license of this journal is the Creative Commons Attribution 4.0 International license (CC BY 4.0).

Authors may also request a compatible license. A list of compatible licenses are found at

Publication license *
License agreement
Never submit passwords through Google Forms.
This form was created inside of WikiJournal of Medicine. Report Abuse - Terms of Service