JANANY Author Submission

The Journal of the American Nurses Association - New York (JANANY)

Author Submission Form
Title of Submission *
Submission Date

Month Day Year
Date
Primary Author's Name *

First Name Last Name
Primary Author’s Job Title & Affiliation *

Job Title Affiliation
Job Affiliation Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Primary Author’s Email Address *
Primary Author’s Phone Number *

Area Code Phone Number
Is the Primary Author an ANA-NY Member
*It will be assumed that the primary author will be the corresponding author, unless indicated.*
Please list other authors, along with credentials and affiliations.
Additional Author's Name

First Name Last Name
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author’s Job Title & Affiliation

Job Title Affiliation
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author's Name

First Name Last Name
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author’s Job Title & Affiliation

Job Title Affiliation
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author's Name

First Name Last Name
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author’s Job Title & Affiliation

Job Title Affiliation
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author's Name

First Name Last Name
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author’s Job Title & Affiliation

Job Title Affiliation
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author's Name

First Name Last Name
Highest Degree, License, Certifications, and Honorary Recognitions
Additional Author’s Job Title & Affiliation

Job Title Affiliation
Highest Degree, License, Certifications, and Honorary Recognitions
CONFLICT OF INTEREST

I declare no actual or potential conflict of interest. I have or may have an actual or potential conflict of interest. Please explain below.
Explanation of conflict of interest
DECLARATION OF MANUSCRIPT NOT SUBMITTED/ NOT BEING CONSIDERED BY OTHER JOURNALS

This manuscript has not been submitted to and or being considered by another journal. This manuscript has been submitted to and being considered by another journal.
ACKNOWLEDGMENT OF FUNDING

This research did not receive any support, financially and in kind. This research received financial support, funding, or grant.
Please identify funding organization, date funding received, and manuscript requirements.
ACKNOWLEDGMENT OF USE OF HUMAN SUBJECTS ,TRAINING & IRB APPROVAL

This research used human subjects and the authors and team members completed human subjects training, and an IRB approval was sought and approved. This research did not use human subjects and the authors and team members did not complete human subjects training, and no IRB approval was sought and approved. Please explain why, below.
Explanation
AFFIRMATION OF MEMBERSHIP IN ANA-NY OR ANOTHER ANA CONSTITUENT

One or more of the authors of this manuscriptis/are member/s of ANA-NY. Please identify them by last name/s
Please identify them by last name/s
AFFIRMATION OF MEMBERSHIP IN ANA-NY OR ANOTHER ANA CONSTITUENT

One or more of the authors of this manuscript is/are member/s of an ANA constituent organization.
Please identify them by last name/s and which ANA constituent organization do they belong
AFFIRMATION OF MEMBERSHIP IN ANA-NY OR ANOTHER ANA CONSTITUENT

No one among the authors of the submitted manuscript is a member of ANA-NY or any of its constituents. Willing to discuss the manuscript with the Editor. Please email journal@anany.org.
Please indicate name of author and contact information of author who the Editor can contact
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**Affixing my signature below as primary author (and a representative of our team), I attest to the veracity of the above checked-off statements and take responsibility for its accuracy. Any inaccurate statements can be cause for rejection of our manuscript and other consequences.
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