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American Psychiatric Association Publishing

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Book Journal DSM SCID

Book Title: Sections, figures, tables or images to be reproduced: Project Name: Name of Author(s): Name of Publisher(s): In which countries your project will be distributed: Journal Name: Year/Volume/Issue: Article title: Sections, figures, tables or images to be reproduced: Are you using the entire article:

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Project Name: Name of Author(s): Name of Publisher(s): In which countries your project will be distributed: Specific portions of the DSM to be reprinted:

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Name of product/software: Brief description of product and intended audience: SCID version requested: For research or clinical trials, provide a brief description of your study with start and end dates: For clinical trials, please tell us how many subjects or patients you intend to screen as well as start/end dates and protocol number: Additional Information Additional information about my project or request:

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Permissions Form