Coping with a traumatic brain injury

This survey will collect information that may be used in upcoming publications and/or related materials on the topic of brain injuries.

Respondent agrees to grant the AUTHOR, Monica Vest Wheeler, use of the following material including: survey, questionnaire and any interview (hereafter referred to as the “MATERIAL”) in the forthcoming book to be published, titled, “Brain Injuries” (hereafter referred to as the “BOOK”)

Respondent hereby grants permission for the non-exclusive right to edit and use the MATERIAL, in whole or in part, in the BOOK and in all future publications, printings, revisions, licensing and other exploitations of the BOOK and MATERIAL, in all languages and in all territories throughout the WORLD, as well as for advertising and/or promotion thereof. Author shall have the right to use the MATERIAL in an audio version of the BOOK and other electronic exploitations of the BOOK and MATERIAL in all media now known or hereafter developed.

Respondent represents and warrants that respondent is fully authorized to grant permission and that use of the MATERIAL in the BOOK, or any other use of the MATERIAL will not infringe upon any copyright or other rights of any third party.

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* 1. Please type your name in the following space to agree to these terms. Thank you!