Letter to physician requesting NCAA Medical Exception Documentation to Support the
Diagnosis of ADD/ADHD and Treatment with Banned Stimulant Medication
I am one of your patients, and I am a student-athlete at Brevard College. The medication you prescribed for my
ADD/ADHD is on the NCAA’s list of banned substances. The NCAA allows for medical exceptions for this medication if
proper documentation is submitted. This documentation must be on file prior with Brevard College Sports Medicine Prior
to beginning any athletic activity. A description of the required documentation is listed below. You can read the NCAA
guidelines by visiting(click on NCAA Drug Testing
). I would appreciate it if you would write a letter
including the appropriate information and attach any other necessary medical records for my medical file at Brevard
Col ege. A sample letter is attached. This must be completed Yearly.
Please return the required documents to:
_____Return directly to Brevard Col ege Sports Medicine at the address listed at the end of this letter.
The following must be included in supporting documentation:
• Student-athlete name and Date of Birth.
• Date of examination or annual fol ow-up evaluation.
• Description of current treatment.
• Prescribed medication(s) and dosage.
• Blood pressure and pulse readings and comments.
• Note that alternative non-banned medications have been considered, and comments.
• Follow-up orders and date of follow-up exam.
• Attach written report summary of comprehensive clinical evaluation:
The evaluation should include
individual and family history, address any indication of mood disorders, substance abuse, and previous history
of ADHD treatment, and incorporate the DSM criteria to diagnose ADHD. Attach supporting documentation,
such as completed ADHD Rating Scale(s) (e.g., Connors, ASRS, CAARS) scores.
• The evaluation can and should be completed by a clinician capable of meeting the requirements detailed
• Documentation from prescribing physician must also include the following:
o Physician name and Specialty (Printed) o Office address and contact information. o Physician signature and date. o A copy of my most recent prescription
_______ _______to release information regarding
my ADD/ADHD prescription to Brevard Col ege Sports Medicine. This information will be kept in my athletic medical
file and will be used for a medical exception claim in the event I am asked to participate in NCAA random drug testing.
Please forward al documentation to:
Colin Covelli, ATC – Head Athletic Trainer, Brevard College
_____________________________________________ _____________________________________ ___________
Parent / Guardian Signature (if under age 18)
Sample ADD/ADHD Treatment Cover Letter from Physician
(Please complete letter on office letterhead)
I am a health care professional trained in the diagnosis and/or treatment of ADD/ADHD.
Mr. Smith is a patient of mine and has been diagnosed with Attention Deficit Disorder with / without hyperactivity (using
DSM-IV criteria) after a comprehensive clinical evaluation.
I used the following instruments to support the diagnosis of ADD/ADHD: (examples are Brown Scales, Conner’s Rating
Scale, DSM-IV ADHD Survey, Conner’s Adult ADHD Rating Scales (CAARS), or the Adult Self-Report Scale (ASRS)). I have
The patient’s ASRS scores are 24 and 13. He has been treated in the past with Adderall, Concerta and Strattera. He is
presently treated with Adderall 15 mg p.o. b.i.d. He was first seen by me on 7-8-08. He was most recently seen on 7-21-
10. He is scheduled to be seen every 6 months. He has been rather well controlled on this regimen. He has shown no
He tried the Strattera and developed a rash. I do not know of other non-controlled medications which would effectively
treat his condition. Most recent pulse was 82 and BP was 110/68.
A copy of all pertinent office notes, tests, clinical evaluations, and the most recent prescription is attached.
Physician Printed Name and Specialty Office Address and Contact Information
ADD / ADHD Medications - Frequently Asked Questions
ADHD Medications Q&A: What Is a Medical Exception and What Is the Process for Obtaining One?
Stimulant medications commonly prescribed to treat ADHD, such as Adderall and Ritalin, are among banned substances
for which a medical exception for a positive drug test may be granted, provided a student-athlete’s institution presents
documentation that those substances have been prescribed by a physician and is supported by a clinical assessment for
What type of ADHD evaluation documentation needs to be submitted to support an ADHD diagnosis and
treatment with banned stimulant medication? What is acceptable and what is not acceptable proof an
evaluation has been conducted?
The documentation should include a comprehensive clinical evaluation, recording observations and results from ADHD
rating scales, a physical exam and any lab work, previous treatment for ADHD, and the diagnosis and recommended
treatment. The physician can provide documentation of the above either with a cover letter and attachments or provide
the medical record. This documentation should be kept on file in the athletics department until such time that the
student-athlete tests positive for the stimulant. A simple statement from the prescribing physician that he or she is
treating the student-athlete for ADHD with said medication IS NOT adequate documentation.
Wil an assessment conducted more than three-five years ago be acceptable?
Yes, in fact the expectation is that for many student-athletes, the evaluation and initiation of treatment likely began
during grade school. Documentation of that evaluation, along with the history of treatment and current prescription,
should be submitted by the student-athlete to their sports medicine staff upon matriculation.
What is required of a student-athlete who for years has been prescribed stimulant medication to treat ADHD
but has not undergone a full assessment?
In order to obtain a medical exception, the student-athlete must undergo a ful assessment as described above. This may
be conducted on campus, through a community mental health service, or by any experienced clinician.
Does a student-athlete need to have an updated letter from the prescribing physician on file each year of
Yes, an annual follow-up with the prescribing physician is the minimum standard, and that can be reflected in a letter
from the physician or a copy of the medical record, with written indication of the current treatment.
Do physicians have to use a certain form when performing the evaluation for ADHD?
There is no specific form physicians need to use to perform an evaluation. The guidelines present the criteria identifying
what to report, and several ADHD rating scales are listed, but it is the totality of the clinician’s evaluation that should be
reflected in the documentation. This evaluation should be conducted by a clinician experienced in assessing ADHD.
Some student-athletes are embarrassed and don’t reveal that they are taking medication for ADHD. How
does the institution address this issue?
The institution should be proactive in communicating the importance to al student-athletes about reporting to sports
medicine all medical issues and medications – in order to avoid loss of eligibility and to respond appropriately in any
medical emergency. The need for this reporting should be expressed to the student-athlete as standard operating
procedure and addressed during initial medical assessments and subsequent health histories.
Does the student-athlete need to first try non-stimulant medication to treat ADHD?
The student-athlete does not need to be put on a trial of non-stimulant medication, but the documentation must note
that a non-stimulant alternative was considered and why the stimulant medication was chosen.
How wil the policy address a student-athlete who tests positive for a banned stimulant prescribed by their
physician but has not undergone a ful assessment for an ADHD diagnosis?
If a student-athlete has not undergone an evaluation and/or cannot produce documents at the time the positive test is
confirmed with the institution, the student-athlete must be declared ineligible until 1) the documentation can be
produced or 2) a drug-test appeal is heard and approved.
Does a student-athlete currently on stimulant medication but lacking a formal evaluation need to
discontinue the medicine in order to undergo the assessment?
If a student-athlete has been on a prescribed stimulant medication, but no evaluation documentation is available, and
the student-athlete will be referred for evaluation to document the diagnosis of ADHD, they can continue the
medication if helpful and they are tolerating it. Clinicians familiar with ADHD regularly see patients who are taking ADHD
medications and have no formal documentation at the time. The evaluation is a clinical evaluation that includes taking a
comprehensive history, evaluation current/ past symptoms, reviewing the effects of medications (including getting
information from the patient’s prescription/med bottle), checklists, etc. There is no need to take the patient off the
medication for evaluation especially if they are doing well.
Insight Newsletter: 1st Quarter, 2013
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