Permissions

Permissions Thank you for your interest in using work published by Health Communications, Inc. To protect copyright and to ensure that our authors are paid for re-publication and dissemination of their work, we require a Permissions Contract to stipulate and validate the terms and conditions of use. Charges vary depending upon usage. We receive requests to print stories and excerpts in many different media. We encourage certain personal uses—such as emailing a story to a family member or friend—that do not require specific permission. We do require that such use be appropriately acknowledged. The following credit line must be included with the story or excerpt: "Title of Story" from "Title of Book," copyright "Date" by "Author's Name," HCI, The Life Issues Publisher, www.hcibooks.com. If you have any questions as to whether your proposed use of Health Communications, Inc.'s material is subject to existing copyright restrictions, please contact us.
Contract for Permissions
Your Contact Information
Name:	Email:
Address:	Phone:
City:	Fax:
State:	Zip:

Title of story selected:
Title of book(s) from which story is selected:
Author:

If this request is for inclusion in book form, please fill out the following information:
Title of Work:	Price:
Type of Work: (e.g., anthology)	Binding:
Author / Editor:	Publication Date:
Publisher: If you are without a publisher at this point, please re-apply for permission when the publisher of your manuscript has been named.	Print Run: Rights: (e.g., North American, World, etc.)

If this request is for broadcast or website posting please fill out the following relevant information:
Type of Show:	Call Letters:
Type of Broadcast:	Web Address:
Name of Host:	Broadcast Date:
Company:

If this request is for a student packet, please fill out the following information:
Number of pages to be photocopied:	Instructor:
Number of packets to be printed:	Start of Term:
College or University:	Course Number:

For other kinds of permission requests, or to provide more details about the information submitted above, please enter the information below:

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