Therapeutic Exemption Use (TUE)

What are TUE forms?

Athletes, like all people, may have illnesses or conditions that require them to take particular medications or undergo procedures. If the medication or method an athlete requires to treat an illness or condition happens to fall under the Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take the needed medicine or method. TUEs are granted according to the International Standard for TUEs (ISTUE), a document outlining the conditions that must be satisfied in order for a TUE to be granted, among others.

How can an athlete apply for a TUE?

The process for an athlete to apply is as follows:

  • Athlete may contact ADAK and ask for information about the TUE Application process.
  • Applications are usually submitted through the Anti-Doping Administration & Management System (ADAMS) or using a paper form.
  • TUE application forms are available on the ADAK Website.
  • The Athlete must fill in all the relevant sections i.e. 1, 6, 7 and 8.
  • The Athlete must have the Physician fill out and sign the TUE Application form (sections 2, 3, 4 and 5) and produce the required supporting documentation and forward it to ADAK for approval.Athletes must apply as soon as the need arises. For substances prohibited In-Competition only, the Athlete should apply for a TUE at least 30 days before his/her next Competition, unless it is an emergency or exceptional situation.

  • Tips on applying for a TUE:

  • Complete the form either through ADAMS or fill out the paper form, either typed or handwritten in block capital letters. If the form is not legible, it is deemed incomplete and will be returned to the athlete.
  • Ensure that your TUE application is complete with all the medical information, tests, laboratory results, imaging studies, clinical information to enable the TUEC to reach a decision in tune with WADA’s documents entitled “Medical Information to Support the Decisions of TUECs/TUE Physician Guidelines” available here. Upload all of your medical information to support the use of the prohibited method or substance in ADAMS, under the Diagnosis information tab.
  • Always keep a copy of all your medical information, especially the initial diagnostic together with laboratory results, imaging studies and physicians’ notes.

  • What are the criteria for granting a TUE?

    An Athlete may be granted a TUE if (and only if) he/she can show, by a balance of probability, that each of the following conditions is met:
  • The Prohibited Substance or Prohibited Method in question is needed to treat an acute or chronic medical condition, such that the Athlete would experience a significant impairment to health if the Prohibited Substance or Prohibited Method were to be withheld.
  • The Therapeutic Use of the Prohibited Substance or Prohibited Method is highly unlikely to 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 acute or chronic medical condition.
  • There is no reasonable Therapeutic alternative to the Use of the Prohibited Substance or Prohibited Method.
  • 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.


    Recognition of a TUE granted by ADAK

    A TUE granted by the ADAK may not be automatically recognized by an International Federation (IF) or a Major Event Organizers (MEO). It is therefore the responsibility of the athlete to check with ADAK if their IF will recognise an existing TUE granted by ADAK.

    Where to send a TUE Application

    For the majority of sports, athletes competing at an international level will be required to submit their TUE application to the International Federation. National level athletes should submit their application to ADAK through Peninah Wahome email at

    Please note

    The application of a TUE takes approximately 21 days to be processed. Please ensure that you submit ALL necessary information required in the documents.