Image Manipulation Disclosure Form
Author Details
Name
Affiliation
Email
Image Details
Image Title / Figure Number
Related Manuscript / Project
Manipulation Disclosure
Cropping
Brightness/Contrast Adjustment
Color Adjustment
Splicing
Annotation
Other
If 'Other', or for additional details, describe the manipulation(s) performed:
Purpose and Justification
Briefly explain the purpose and necessity of the image manipulations:
Compliance Statement
Does the manipulation comply with journal/institutional guidelines?
Yes
No
If 'No', explain:
Author Signature
Date