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Therapeutic Use Exemptions

Athletes are responsible for informing their prescribing physicians that they fall under the IGF's anti-doping rules and for checking with them whether their treatment includes a prohibited substance or method or not. The IGF Anti-Doping Medication Check may help assist in this process. If the required treatment includes a prohibited substance or method and there is no reasonable permitted alternative, the athlete must apply for a TUE.

Athletes must absolutely avoid taking a medication with a prohibited substance without a valid TUE and should always declare on the doping control forms during sample collection any medications and supplements taken within the seven days prior to sample collection (regardless of what the medication contains and whether a TUE has been granted).

What is a Therapeutic Use Exemption (TUE) and when is it needed?

Athletes may have illnesses or conditions that require them to take medications or undergo procedures. If the medication or method an athlete is required to use to treat an illness or condition is prohibited according to the World Anti-Doping Agency (WADA) Prohibited List in force, a TUE may give that athlete the authorisation to use that substance or method while competing without invoking an Anti-Doping Rule Violation (ADRV) and applicable sanction. Applications for TUEs are evaluated by a panel of physicians, the TUE Committee (TUEC).

Athlete support personnel do not need a TUE when prescribed a medication that contains a prohibited substance but the IGF recommends for athlete support personnel to keep their prescription on them.

What are the criteria for granting a TUE?

All of the four following criteria must be met (for more details, please refer to Article 4.2 of the International Standard for TUEs):

  • The athlete has a clear diagnosed medical condition which requires treatment using a prohibited substance or method;
  • The therapeutic use of the substance will not, on the balance of probabilities produce significant enhancement of performance beyond the athlete's normal state of health;
  • The prohibited substance or method is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative; and
  • The necessity to use that substance or method is not a consequence of the prior use (without a TUE) of a substance or method which was prohibited at the time of use.

Who should apply to the IGF for a TUE, where and when to apply?

Athletes in the IGF's Registered Testing Pool (RTP) or participating in an international event listed below will need to apply to the IGF for a TUE or, in the case of an already existing and valid national TUE, ask the IGF to recognise the TUE. National-Level Golf Athletes are to apply to their National Anti-Doping Organisation (NADO). Athletes competing in major events such as the Olympic Games may also be requested to follow the Major Event Organiser's procedure to apply for a TUE between specific dates.

The international events listed in the 2021 IGF Anti-Doping Policy that require a TUE granted or recognised by the IGF are the:

  • Summer Olympic Games
  • IGF World Amateur Team Championships

It is important for athletes to submit the TUE application to the IGF plenty of time ahead of when it is needed and at least 30 days before your competition if needed in-competition to allow time for the application process.

How to apply to the IGF for a TUE?

Please download the IGF TUE Application Form, and once duly completed in English and signed, send it together with the required medical file to . Your TUE application must be submitted in typing or legible capital letters.

The medical file must include:

  • A comprehensive medical history, including documentation from the original diagnosing physician(s) (where possible);
  • The results of all examinations, laboratory investigations and imaging studies relevant to the application.

Any TUE application that is not complete or legible will not be dealt with and will be returned for completion and re-submission.

To assist you and your doctor in providing the correct medical documentation, the IGF suggests consulting WADA's general TUE application checklist or WADA's checklist specific to your condition if it is available here as well as the Medical Information to Support the Decisions of TUECs for guidance on specific common medical conditions, treatments, substances.

Keep a complete copy of the TUE application form and all medical information submitted in support of your application, and proof that it has been sent.

Upon receipt of a TUE application, the IGF Anti-Doping Office will do an initial check and forward it to the IGF TUE Committee for their decision. The IGF Anti-Doping Office will contact you if the IGF TUE Committee requires any further information and once the decision is made.

Can I get a retroactive TUE?

You may only apply retroactively for a TUE to the IGF if:

  • You required emergency or urgent treatment of a medical condition;
  • There was insufficient time, opportunity or other exceptional circumstances that prevented you from submitting the TUE application, or having it evaluated, before getting tested;
  • You tested positive after using a substance out-of-competition that is only prohibited in-competition (for example glucocorticoids).

In rare and exceptional circumstances and notwithstanding any other provision in the ISTUE, you may apply for and be granted retroactive approval for a therapeutic use of a prohibited substance or method, if considering the purpose of the World Anti-Doping Code, it would be manifestly unfair not to grant a retroactive TUE.

This unique retroactive TUE will only be granted with the prior approval of WADA (and WADA may in its absolute discretion agree with or reject the IGF's decision).

Important note on retroactive TUEs

Using a prohibited substance or method without a TUE could result in an Anti-Doping Rule Violation.

In case an application for a retroactive TUE is necessary following sample collection, you are strongly advised to have a medical file prepared and ready to submit for evaluation.

How to submit a request for recognition of my national TUE to the IGF?

Athletes should contact the IGF ( in order to request international recognition of any valid national TUE.

In accordance with the IGF Anti-Doping Policy, TUEs that have been issued by the National Anti-Doping Organisations (NADOs) in line with the criteria set out in the International Standard for Therapeutic Use Exemptions will automatically be recognised by the IGF for the purposes of an athlete's participation in an IGF International Event as listed in the IGF Anti-Doping Policy.

When will I receive a decision on my TUE application (or request for recognition)?

The IGF's TUEC will render a decision as soon as possible, and usually within 21 days from the date of receipt of the complete TUE application (or request for recognition).

What if I need to renew my TUE?

Each TUE has a specific duration, at the end of which it expires automatically. Should you need to continue to use the prohibited substance or method, it is your responsibility to submit a new application for a TUE with updated medical information ahead of the expiry date, so that there is sufficient time for a decision to be made prior to the expiry of the current TUE.

Important note:
The presence (following sample collection), use, possession or administration of the prohibited substance or method must be consistent with the terms of your TUE. Therefore, if you require a materially different dosage, frequency, route or duration of administration, you should contact the IGF, as you may be required to apply for a new TUE. Some substances and dosages, e.g. insulin, are often modified during treatment and these possible fluctuations should be mentioned by the treating physician in the TUE application and would usually be accepted by the IGF's TUEC.

What if my TUE application to the IGF is denied?

A decision to deny a TUE application will include a written explanation of the reason(s) for the denial. If it is not clear to you, please contact the IGF to understand exactly why the TUE was denied. Sometimes, there may be a critical piece of information, diagnostic test, laboratory results missing, etc. In which case, you should re-apply to the IGF.

You and/or your NADO may refer the matter to WADA for review no later than 21 days after notification of the IGF's TUEC decision. You should send WADA the same information that you submitted to the IGF, and on which the decision to deny the TUE was based on, via a secure on-line method or by registered mail at: WADA Medical Department, World Anti-Doping Agency, Stock Exchange Tower, 800 Place Victoria (Suite 1700), P.O. Box 120, Montreal (Quebec) H4Z 1B7, Canada

The email address to enquire and/or send the request for review is:
WADA is not obliged to proceed with a request for a review. In that case, you and/or your NADO may appeal to the Court of Arbitration of Sport (CAS).

What if my national TUE is not recognised by the IGF?

You and/or your NADO have 21 days from the date of decision to refer the matter to WADA for review. The email address to enquire and/or send the request for review is: . Alternatively, you may send to WADA's Medical Department's postal address provided in the answer above.

The same information that was provided to your NADO should be submitted to WADA. Please use a secure on-line method unless sending by registered mail. Pending WADA's decision, your NADO TUE remains valid for national-level competitions and out-of-competition testing only.

If the matter is not referred to WADA for review, your NADO must determine whether the original TUE that was granted should remain valid for national-level competition and out-of-competition testing.

Will my medical information be treated in a confidential manner and how long will TUE and medical information be kept?

All the information contained in a TUE application, including the supporting or non-medical information and any other information related to the evaluation of your TUE request is kept strictly confidential and treated in accordance with the Athlete's Declaration contained in the IGF's TUE Application Form. All members of the TUEC and any other authorised recipients of your TUE request and related information (as described in the Athlete's Declaration) are subject to a professional or contractual confidentiality obligation.

Please review the terms of the Athlete's Declaration carefully. In particular, note that should you wish to revoke the right of the IGF's TUEC to obtain the information related to your TUE in accordance with the Athlete's Declaration, your TUE application will be deemed withdrawn without approval (or recognition) being granted.

As per the IGF Athlete Information Notice on ADAMS, the athlete's personal information, TUE application details and decision will be uploaded in WADA's Anti-Doping Administration & Management System (ADAMS).

Your TUE request-related information will be retained by the IGF and any other authorised recipients for no longer than necessary for the purposes stated in the Athlete's Declaration, in accordance with the retention times found in the International Standard for the Protection of Privacy and Personal Information. TUE certificates or rejection decisions will be retained for 10 years and TUE application forms and supplementary medical information will be retained for 12 months from the expiry of the TUE.

Contact information - further questions

For further information about TUEs, please contact .
You may also find your answer on WADA's Q&A on TUEs.

For any further questions in relation to the IGF's personal information practices, please contact .

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