AACC’s Lab Tests Online 1
Intellectual Property Use Request Form
Lab Tests Online®
Intellectual Property
Third-Party Use
Request Form
Thank you for your interest in AACC’s Lab Tests Online®.
Please complete the information below so that we can better understand your request.
Date: ______
I. Company Information
Submitted by: ______
Title: ______
Company/Organization: ______
Address: ______
City/State: ______
Zip: ______
Country: ______
Phone: ______
E-mail:______
URL:______
Identify your company as: Commercial Not-for-profit
Enter your EIN/TIN: ______
Please describe your business concept and products and/or services you offer:
______
______
Please describe your target market(s) and customers:
______
______
If your company is a lab, please indicate the volume of tests performed annually and information on the accreditation:
______
______
II. Type of Request
Is this a request to:
License
(see Section III)
Reprint
(see Section IV)
Other (e.g., link or use of logo)
(see Section V)
------For License Requests------
III. Details of Request
A. Please identify the specific intellectual property that you are interested in licensing.
What content areas?
Test articles Condition/Disease articles Screening articles
Feature articles News articles
Other (specify) ______
B. Will you want to licenseALL of thearticles currently found in the requested content area(s)?
Yes No
If no, specify exactly whicharticlesyou are interested in licensing (include titles and/or URLs)?
Enteron another sheet if necessary.
______
______
______
C. Will you want to receive new and/or updates to articles in the selected content areas during the duration of the period of use? Yes No
D. Please describe how and why you would like to license AACC’s Lab Tests Online® intellectual property:
(Include where and how the information will be featured, is it for print or electronic distribution,who you expect to access it, how many people you expect to access it, and your objective in featuring the content and reaching the audience. Examples or mock-ups are encouraged.)
______
______
______
______
______
E. Please describe the revenue model that will support your site/publication.
______
______
______
______
______
F. Will you charge a fee for access to the intellectual property? Yes No
G. Will you receive fees from any other party to fund your purchase of the intellectual property (if applicable) and/or post/provide access to it? Yes No
If so, please specify name of business/entity, nonprofit/for-profit status and fees charged:
______
______
______
H. Time period during which you would like to license this intellectual property:
Start Date: ______End Date: ______
I. Lab Tests Online frequently updates its pages as new research and technology advances warrant. What is the expected shelf-life of the products in which you plan to incorporate AACC’s Lab Tests Online® intellectual property?
A statement is required alerting readers that updated content can be found at labtestsonline.org.
J. Describe how the use of AACC’s Lab Tests Online® intellectual property would benefit your company:
______
______
______
______
K. Describe how your use of AACC’s Lab Tests Online® intellectual property would benefitLab Tests Online®:
______
______
______
______
------For Reprint Requests------
IV. Details of Request
A. Please identify the specific intellectual property that you are interested in reprinting.
What content areas?
Test articles Condition/Disease articles Screening articles
Feature articles News articles
Other (specify) ______
B. Will you want to reprint ALL of the articles currently found in the requested content area(s)?
Yes No
If no, specify exactly which articles you are interested in reprinting (include titles and/or URLs)?
Enter on another sheet if necessary.
______
______
______
C. Please describe how and why you would like to reprint AACC’s Lab Tests Online® intellectual property:
(Include where and how the information will be featured, is it for print or electronic distribution, who you expect to access it, how many people you expect to access it, and your objective in featuring the content and reaching the audience. Examples or mock-ups are encouraged.)
______
______
______
______
D. Please describe the revenue model that will support your publication.
______
______
______
______
______
E. Will you charge a fee for access to the intellectual property? Yes No
F. Will you receive fees from any other party to fund your purchase of the intellectual property (if applicable) and/or post/provide access to it? Yes No
If so, please specify name of business/entity, nonprofit/for-profit status and fees charged:
______
______
______
G. Time period during which you would like to use this intellectual property:
Start Date: ______End Date: ______
H. Lab Tests Online frequently updates its pages as new research and technology advances warrant. What is the expected shelf-life of the products in which you plan to incorporate AACC’s Lab Tests Online® intellectual property?
A statement is required alerting readers that updated content can be found at labtestsonline.org.
I. Describe how the use of AACC’s Lab Tests Online® intellectual property would benefit your company:
______
______
______
______
J. Describe how your use of AACC’s Lab Tests Online® intellectual property would benefit Lab Tests Online®:
______
______
______
______
------For Other Requests------
V. Details of Request
A. What are you requesting?
Use of Lab Tests Online logo
Linking to Lab Tests Online
Both
Other (specify) ______
______
B. Please provide additional details related to your request such as the following:
(Include where and how the information will be featured, is it for print or electronic distribution, who you expect to access it, how many people you expect to access it, and your objective in featuring the content and reaching the audience. Examples or mock-ups are encouraged.)
______
______
______
______
______
C. Time period during which you would like to use this [logo, link or other]:
Start Date: ______End Date: ______
D. Describe how the use of AACC’s Lab Tests Online® [logo, link or other] would benefit your company:
______
______
______
______
E. Describe how your use of AACC’s Lab Tests Online® [logo, link or other] would benefit Lab Tests Online®:
______
______
______
______
Thank you.