ACR Permission Request Form

ACR Permission Request Form
The American College of Radiology (ACR) handles all requests to reproduce and/or license ACR developed content. All materials requested must be used verbatim with proper citation.

Please include the full reference of the material you wish to use (journal or book name, year of publication, volume and issue numbers, author, file of article, figure numbers where appropriate, etc.).

We also require a detailed overview of how you intend to use the material (i.e., in a book).
Name

First NameLast Name
Job Title
Organization
Organization Type
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
ACR Section (Select all that apply)

Other
What information do you wish to reprint/reference?
ACR Publication Title or Content
Publication Date
Version/Volume
ACR Content to be used
Please include 1) Publication Title, 2) Publication Date, and 3) Version/Volume if applicable.
URL (your publication)
Authors/Editors:
Your Publication/Project Title
Details of content usage in your publication
Distribution Method
URL
Use Category
Will the publication be:
Language
Attachments

Upload a File

Cancelof
ACR STAFF ONLY
Request Approval
Comments/ additional information
This field is required for all ACR stafff.
Should be Empty: