In the case of the PAD guidelines, if the recommended tools are selected and used as published, no further permission is indicated. However, if the organization were to decide to use a tool in a way that was not intended, a discussion with the author is indicated. If the recommended tools are selected for clinical use (not for commercial use or publication) and are used as published, no further permission is usually indicated. This issue is complex and as a general principle, if the rules for use are not explicitly stated, the author should be contacted for permission to use the tool. The appropriate publication where the tool was first described should be cited. For instance, the American Association for Critical-Care Nurses (AACN) holds the copyright for the English version of the Critical-Care Pain Observation Tool. When used clinically, it should be referenced as follows: “Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the Critical-Care Pain Observation Tool in adult patients. Am J Crit Care. 2006;15(4):420–427. http://ajcc.aacnjournals.org/content/15/4/420.short.” When used for commercial purposes or publication, permission for use is obtained from AACN (M. Muscat, personal communication, April 28, 2014). Tools not readily available online often require permission for use.