Therapeutic Use Exemptions (TUE)

A Therapeutic Use Exemption (TUE) allows athletes to use a prohibited substance or method for legitimate medical treatment while remaining compliant with anti-doping regulations.

Apply for a TUE Download TUE Form

What is a TUE?

Athletes may experience illnesses or conditions that require specific medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the WADA Prohibited List, a TUE grants that athlete the authorization to take the needed medicine without committing an Anti-Doping Rule Violation (ADRV).

The TUE process is strictly regulated by the International Standard for Therapeutic Use Exemptions (ISTUE) to ensure that the fundamental principles of clean sport are protected while safeguarding athlete health.

Important Warning

Using a prohibited substance or method without a valid TUE may result in an Anti-Doping Rule Violation and subsequent sanctions.

Athlete taking medication

Who Should Apply?

Determine your athlete level to understand when and how to apply for a TUE.

Your status as an International-Level Athlete is determined directly by your sport's International Federation (IF).

How to know if you qualify:

  • You are included in your IF’s Registered Testing Pool (RTP). (Your IF will notify you if you are included).
  • You participate in your IF’s highest-level International Events.
Tip: If you are unsure of your status, check directly with your IF or through your National Federation.

TUE Application Guidelines:

  • If you already have an EGY-NADO TUE: Check with your IF to see if they recognize it automatically or if you need to formally apply for their recognition before competing in an International Event.
  • If you do not have an EGY-NADO TUE: Check with your IF to confirm if you are considered an International-Level Athlete for your upcoming event and follow their specific application process.

EGY-NADO defines National-Level Athletes in accordance with the World Anti-Doping Code. You must apply for a TUE in advance if you meet any of the following criteria:

Who qualifies:

  • Athletes holding a professional Egyptian license to compete.
  • Athletes included in the EGY-NADO Registered Testing Pool, or any other EGY-NADO testing pool.
  • Athletes participating in National Competitions, selection events, or who are selected for senior national teams.
  • Athletes representing Egypt internationally who are not part of an International Federation's (IF) Registered Testing Pool.
Exception: If your IF classifies you as an International-Level Athlete, you fall under the International category instead.

Important Deadlines & Rules:

  • Competitions: You must have an approved TUE in place at least seven (7) days prior to the start of your event, and it must remain valid for the entire duration of the competition.
  • National Teams: Apply for a TUE as soon as you are selected for a national team. Even if you later lose your spot due to injury or performance, you still qualify as a National-Level Athlete for the remainder of that calendar year and must keep your TUE updated, as you can still be tested.

If you do not meet the criteria for International or National-Level Athletes, you fall into this category.

TUE Application Guidelines:

  • Retroactive Applications: You are eligible for a Retroactive TUE. This means you do not need to apply in advance; you only need to submit an application if you are tested and are currently using a prohibited medication or method for therapeutic reasons.
  • Be Prepared: Applying retroactively allows you the opportunity to seek an exemption, but it does not guarantee approval. The EGY-NADO TUE Commission must still ensure your case meets all International Standard for TUEs (ISTUE) criteria. We highly recommend gathering and storing all relevant medical documentation in advance so you are fully prepared in the event you are tested.

TUE Approval Criteria

A TUE will only be granted if the application demonstrates that all four of the following criteria are met (as per the ISTUE):

1

Diagnosed Condition

The athlete has a clear diagnosed medical condition which requires treatment using a Prohibited Substance or Method.

2

No Performance Enhancement

The use will not produce any additional enhancement of performance beyond a return to a normal state of health.

3

No Permitted Alternative

There is no reasonable therapeutic alternative to the use of the Prohibited Substance or Method.

4

Not Caused by Prior Use

The necessity for use is not a consequence of prior non-therapeutic use of any Prohibited Substance.

Retroactive TUEs

A Retroactive TUE allows an athlete to apply for an exemption after they have already been tested or used a prohibited substance. This is strictly limited to exceptional circumstances.

Note: Applying for a retroactive TUE does not guarantee approval. If denied, any positive test may lead to an Anti-Doping Rule Violation.

Emergency or acute medical treatment of a medical condition was necessary.
There was insufficient time, opportunity or other exceptional circumstances that prevented the Athlete from submitting the application prior to sample collection.
The athlete is neither an International-Level nor a National-Level Athlete and was tested unexpectedly.

How to Apply

Follow these steps to submit a complete and accurate TUE application.

1

Check the Prohibited List

Verify if the medication or method prescribed by your doctor is on the current WADA Prohibited List.
2

Consult Your Physician

Discuss alternative, permitted medications. If none exist, request their assistance in preparing the TUE medical file.

3

Determine Your Athlete Level

Check whether you are an International or National-Level Athlete to know which organization to submit your application to.

4

Prepare Medical Documentation

Gather a comprehensive medical history, diagnostic test results, and a supporting statement from your specialist.

5

Submit Your Application

Submit the completed form and documents securely through ADAMS, or via the official forms.

6

Await TUE Committee Review

The TUE Committee evaluates the application (normally within 21 days). You will be notified of the decision in writing.

Required Medical Documents

A complete application prevents delays. Ensure you attach the following documentation.

Comprehensive Medical History

Detailed clinical history outlining symptoms, onset, and previous treatments attempted.

Physician Documentation

A signed statement from a relevant medical specialist supporting the diagnosis.

Laboratory Reports

Copies of all relevant blood, urine, or other lab test results.

Diagnostic Imaging

X-rays, MRIs, CT scans, or other imaging reports confirming the diagnosis.

Checklists for TUE Applications TUE Physician Guidelines

Note: All costs related to the medical examinations and the TUE application process are the sole responsibility of the athlete.

Downloads & Official Resources

TUE Application Form

Standard form for national athletes.

Download PDF

Bilingual TUE Form

Application form (Arabic/English).

Download PDF

ISTUE

WADA International Standard for TUEs.

Download PDF

Privacy Standard

Data Protection & Privacy Policy.

Download PDF

Frequently Asked Questions

The EGY-NADO TUEC must render a decision as soon as possible, and usually within 21 days from the date of receipt of the complete TUE application that includes all required medical information.

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

Furthermore, a failure to render a decision within a reasonable time on a properly submitted application for the granting or recognition of a TUE or for the review of a TUE decision by WADA shall be considered a denial of the application, thus triggering the applicable rights of review/appeal.

You may appeal the denial decision of a TUE to the EGY-NADO Appeal committee.

Each TUE has a specific duration, at the end of which it expires automatically. Should you need to continue to use the prohibited substance/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/method shall 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 EGY-NADO, 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 EGY-NADO TUEC.

No. A TUE granted by EGY-NADO is only valid at the National level.

If you are or become an International-Level Athlete or compete at Major Games, that TUE will not be valid unless it is recognised by the relevant International Federation (IF) or Major Event Organisation (MEO). It is your responsibility to check if a EGY-NADO’s TUE is automatically recognised by such IF or MEO.

MEOs are the continental associations of National Olympic Committees and other international multi-sport organisations that function as the ruling body for any continental, regional or international event, e.g., African Games, Commonwealth Games etc.

EGY-NADO can assist you in the determination of your level as per the EGY-NADO Anti-Doping Rules and the resulting TUE application requirements, and, should the need occur, assist you in presenting your EGY-NADO’s TUE to an IF or MEO for recognition. Please contact EGY-NADO for assistance.

You or EGY-NADO have 21 days to refer the matter to WADA for review after notification of the non-recognition. You should send the same information that you submitted to EGY-NADO, and on which their TUEC based their decision, via a secure online 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 e-mail address to enquire and/or send the request for review is: medical@wada-ama.org

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

All the information contained in your TUE application, including the supporting 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 ADAMS TUE process and in the EGY-NADO’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 announcement carefully. In particular, note that if you wish to revoke the right of the EGY-NADO’s TUEC to obtain information related to your TUE application in accordance with the athlete’s acknowledgment, your TUE application will be considered withdrawn without consent being granted.

Information related to your TUE application will be retained by EGY-NADO and any other approved recipients that are not more than necessary for the purposes set out in the sports announcement, in accordance with the international standard for protecting privacy and personal information.