Four major clinical journals have recently published the Vancouver Declaration, Uniform Requirements for Manu scripts Submitted to Biom?dical Journals.1-4 This document represents an agreement among several journal editors that manuscripts submitted to them for publication should be prepared in accordance with specific requirements. The agree ment further stipulates that the requirements about manuscripts stated in a journal's instructions to authors should not contradict any of the uniform requirements. The details of style in the Vancouver Declaration apply to manuscripts, and the co-operating journals are not required to use any of the style details as their publication style. Neverthe less, the editors of some of the co-operating journals have decided to use most, or all, of the manuscript style details for their pub lication styles. The Annals of Internal Medicine is taking that step. Beginning in our July 1979 issue we shall use the form of refer ences outlined in the Vancouver Declaration for all papers pub lished in the journal. (This is the form used for the references at the end of this paper.) In January 1980 other journals and Index Medicus will begin to use the new forms.