Therapeutic Use Exemption (TUE) Form

What is a TUE?

Athletes, like all others, may have illnesses or conditions that require them to take medications. If the medication an athlete is required to take happens to fall under the World Anti-Doping Agency’s Prohibited List, a therapeutic use exemption (TUE) can give the athlete authorization to take the needed medicine.

Athletes are not automatically granted authorization and must ensure they follow the appropriate process for their sport and competition level.

Who should apply for a TUE to the ITA?

Please verify if you fall into the category of International Level Athlete in your sport using this table. If you do, you should submit your application directly to the ITA.

During the Period of the Games.

All Athletes participating in the Olympic Games should apply to the ITA office located in the polyclinic of the OIympic Village.

The Period of the Games for the Tokyo 2020 summer Olympic Games is from 23 July to 8 August 2021.

Under what circumstances will a TUE application be approved?

A TUE application will be considered by the ITA under the following circumstances:

  • The Prohibited Substance or Prohibited Method in question is needed to treat a diagnosed medical condition supported by relevant clinical evidence. 
  • The Therapeutic Use of the Prohibited Substance or Prohibited Method will not, on the balance of probabilities, produce any additional enhancement of performance beyond what might be anticipated by a return to the Athlete’s normal state of health following the treatment of the medical condition.
  • The Prohibited Substance or Prohibited Method is an indicated treatment for the medical condition, and there is no reasonable permitted Therapeutic alternative. 

The necessity for the Use of the Prohibited Substance or Prohibited Method is not a consequence, wholly or in part, of the prior Use (without a TUE) of a substance or method which was prohibited at the time of such Use. 

Please verify the status of your medication here 

Examples include:

  • Insulin for the treatment of Type 1 Diabetes Mellitus;
  • Beta-2 Agonist inhaler, such as terbutaline, for the treatment of asthma; or
  • Methylphenidate for the treatment of ADD or ADHD.

How do I apply for a TUE?

Application timelines and information:

  • Please fill and follow the instructions on the TUE form.
  • A complete TUE application can be reviewed within 21 days of receipt of a complete application, unless in exceptional circumstances.
  • The ITA will contact the athlete once a decision has been rendered on the application, or if more information has been deemed necessary.
  • Costs incurred for the completion of the TUE application form or additional investigations, examinations, or imaging studies are the responsibility of the athlete.
  • Incomplete applications will be returned and will need to be resubmitted with additional information.
  • Keep a copy of your application form and medical file for your records.

What is a retroactive TUE?

The International Standard for TUEs specifies in which conditions retroactive TUEs can be granted:

An Athlete may apply retroactively for a TUE (but must still meet the conditions in Article 4.2 of the ISTUE) if one of any of the following exceptions applies:

a. Emergency or urgent treatment of a medical condition was necessary;

b. There was insufficient time, opportunity or other exceptional circumstances that prevented the Athlete from submitting (or the TUEC to consider) an application for the TUE prior to Sample collection;

c. Due to national level prioritization of certain sports, the Athlete’s National Anti-Doping Organization did not permit or require the Athlete to apply for a prospective TUE (see comment to Article 5.1);

d. If an Anti-Doping Organization chooses to collect a Sample from an Athlete who is not an International-Level Athlete or National-Level Athlete, and that Athlete is Using a Prohibited Substance or Prohibited Method for Therapeutic reasons, the Anti-Doping Organization must permit the Athlete to apply for a retroactive TUE; or

e. The Athlete Used Out-of-Competition, for Therapeutic reasons, a Prohibited Substance that is only prohibited In-Competition.

What should I do in case of an emergency or acute treatment?

Your health and safety come first. Any decision made regarding your treatment plan should be done in consultation with your physician. Once your treatment is being managed, contact us to determine your TUE requirements, and to download the application form if required.

What should I do if I have surgery?

Prior to surgery, ask your physician for a list of the medications that will be used. Contact us to determine your TUE requirements, and to download the application form if required.

What should I do if my competition level changes?

TUEs granted by National Anti-doping Agencies are valid only at national-level, unless otherwise stated in your International Federation’s anti-doping rules. If at any time you are included in your IF’s Registered Testing Pool (RTP) or compete at an international level, you must comply with the IF TUE requirements. You can contact your NADO or the ITA to determine whether your national TUE is valid for international competition or ask for recognition if necessary.

Downloads and useful information:

You can download the TUE form here.

List of National anti-Doping Organizations (NADOs) here

List of International Federations here