Copyright authorization request

Please complete this form to request permission for use of Abbott materials. If you have questions, please contact your Abbott representative. If you are requesting authorization for more than one product, please submit multiple requests. Direct procedural questions to copyright@abbott.com.

REQUESTOR NAME*

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REQUESTOR COMPANY

BUSINESS ADDRESS*

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CITY

STATE (PROVINCE/TERRITORY)

ZIP( POSTAL CODE)*

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COUNTRY

CONTACT PHONE*

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EMAIL ADDRESS*

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ABBOTT CONTACT/REP NAME

NAME OF ABBOTT PRODUCT REQUESTED (PLEASE BE AS SPECIFIC AS POSSIBLE)

PROJECT TITLE*

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REQUESTOR MATERIAL PUBLISHER NAME*

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COST CENTER, IF KNOWN FROM ABBOTT REP

By completing this form, you are making a request to use one or more copyrighted works (“the Work”) owned by Abbott Laboratories and its affiliates (“Abbott”) and agree to abide by the conditions set forth below in connection with use of the Work.

(i) Abbott grants non-exclusive permission to reproduce the Work solely for the purpose of education.

(ii) Nothing contained in any release, permission or authorization by Abbott to use the Work shall be deemed to convey or transfer any title, right, or interest in or to the Work

(iii) Full Acknowledgment shall be provided to Abbott for the Work: “Reproduced with Permission of Abbott”.

(iv) Editing and/or creating derivative works is expressly prohibited.

(v) None of the Work shall be used beyond the scope as authorized or in a disparaging manner against Abbott, any Abbott representative, Abbott product, or Abbott customer.

(vi) Abbott reserves the right to revoke any authorization if the purpose of use is found to conflict with Abbott’s policies, to violate law, to be generally inappropriate, or to go beyond the permitted scope.

We are collecting this personal information in order to respond to the inquiry you are sending via this Contact Us form. Abbott and Abbott partners understand the importance of protecting your information and will use your information for the sole purpose of responding to your inquiry. Abbott is a global company so a response to your inquiry may require assistance from Abbott organizations in other countries. Therefore, your information may be transferred to other countries that may not have equivalent laws protecting personal information.