Doping Control Officer’s Training Tool Kit...The List of Prohibited Substances and Methods (Li...

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Doping Control Officer’s Training Tool Kit Manual Version 3.0 – May 2011

Transcript of Doping Control Officer’s Training Tool Kit...The List of Prohibited Substances and Methods (Li...

Page 1: Doping Control Officer’s Training Tool Kit...The List of Prohibited Substances and Methods (Li st), updated annually by WADA, is the International Standard defining what is prohibited

Doping Control Officer’s Training Tool Kit

Manual

Version 3.0 – May 2011

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DCO Manual Index © WADA – Version 3.0 – May 2011

Doping Control Officer Training Tool Kit – DCO Manual Index

Doc Number Document Title

2 Introduction 2.2 Overview of Anti-Doping

3 Sample Collection Personnel

3.1 DCO Roles and Responsibilities 3.2 ADO-DCO Agreement (sample) 3.3 Recruiting and Training Chaperones 3.4 Chaperone Responsibilities / Code of Conduct Form

4 Preparation for Testing

4.1 Authorization and Preparation for Testing 4.2 Doping Control Stations

5 Athlete Notification and Chaperoning

5.1 Athlete Notification Procedure 5.2 Recording Entry/Exit of the Doping Control Station 5.3 Conducting Out-of-Competition Testing

6 Doping Control Procedure

6.1 Urine Sample Collection Procedure 6.2 Urine Sample Processing Procedure 6.3 Measuring Specific Gravity 6.4 Partial Sample Procedure 6.5 Additional Sample Procedure 6.6 Completion of the Sample Collection Session 6.7 Modifications for Testing Athletes with a Disability 6.8 Modifications for Testing Athletes who are Minors 6.9 Reporting a Potential Failure to Comply

7 Doping Control Documentation

7.1 Completing the Doping Control Form v5 7.2 Copy of the WADA Doping Control Form v5 7.3 Completing the Chain of Custody Form v3 7.4 Copy of the WADA Chain of Custody Form v3 7.5 Completing the DCO Report Form v3 7.6 Copy of the WADA DCO Report Form v3 7.7 Completing the Supplementary Report Form v2 7.8 Copy of the WADA Supplementary Report Form v2 7.9 Completing the Unsuccessful Attempt Report Form v1 7.10 Copy of the WADA Unsuccessful Attempt Report Form v1

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DCO Manual Index © WADA – Version 3.0 – May 2011

Doc

Number Document Title

8 Post Sample Administration

8.1 Sending Samples to the Laboratory 8.2 Returning Paperwork to ADO

Please be advised that this information is subject to change at anytime and that in case of any discrepancy between this information and the World Anti-Doping Code, the Code prevails. Always check with your International Federation, National Anti-Doping Organization or National Federation for the most up-to-date anti-doping regulations.

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2.2 Overview of Anti-Doping © WADA – DCO Manual - Version 3.0 – May 2011

2.2 Overview of Anti-Doping

Purpose

The purpose of this section is to provide participants with an overview of the structure and programs of the Anti-Doping Organization (ADO) training the DCOs, to provide an introduction to the World Anti-Doping Program as well as to provide participants with a general overview of various areas of doping control.

World Anti-Doping Agency

WADA was created on 10 November 1999, pursuant to the Lausanne Declaration on Doping in Sport. WADA is funded equally by national government contributions and by the International Olympic Committee. WADA is governed by a 38-member Foundation Board and a 12-member Executive Committee, each composed by equal numbers of representatives from governments and the Olympic Movement. WADA’s mission is to promote, coordinate, and monitor, at the international level, the fight against doping in sport in all its forms.

The World Anti-Doping Code

The Code is the core document that provides the framework for harmonized anti-doping policies, rules, and regulations within sport organizations and among public authorities. The Code first came into force in January 2004. The Code was always intended to be a living document, evolving to meet the needs of the anti-doping community. As a result, and according to Article 23.6: Modification of the Code, WADA initiated a consultation process in 2006 involving three stages of stakeholder consultation. The revised Code was adopted during the Third World Conference on Doping in Sport in November 2007. The revised Code went into effect on 1 January 2009. In addition to the core document of the Code, the following five International Standards are an integral part of the Code, even if they are published as separate documents: Prohibited List (List):

Lists, by category or by name, substances and methods which are prohibited in sport. Distinguishes those prohibited at all times from those prohibited in competition only.

Testing:

Sets out all of the mandatory, step-by-step requirements to be followed for doping control, from test planning and the selection of an Athlete for testing to the transportation of samples to the laboratory inclusively. The International Standard for Testing also outlines mandatory requirements for the submission of whereabouts information by certain athletes.

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Therapeutic Use Exemption (TUE):

Provides for the right of Athletes to undergo medical treatment under certain conditions. While most common illnesses can be treated with medications that do not contain prohibited substances, the Code allows for Athletes to apply for a therapeutic use exemption to enable them to use, for a legitimate medical condition, an otherwise prohibited substance or method.

Laboratory:

Sets out all the proper, step-by-step procedures to be followed by laboratories accredited by WADA in performing analyses for doping control, from the time the laboratory receives a sample, to the reporting of results to the testing authority, including the safeguarding of remaining samples.

Protection of Privacy and Personal Information:

Ensures that all relevant parties involved in anti-doping in sport apply suitable privacy protection in relation to the collection and use of personal data – such as that relating to whereabouts, doping control and TUEs.

Partners in the Fight against Doping

Public Authorities

United Nations Educational, Scientific and Cultural Organization (UNESCO) Responsible for the development and implementation, alongside national governments, of the International Convention against Doping in Sport. The UNESCO International Convention against Doping in Sport is an international legal instrument, which gives the governments of signatory countries a legal framework for harmonizing efforts in the fight against doping in sport and aligning their domestic legislation with the World Anti-Doping Code.

National Governments

Public authority responsible for ratifying, accepting, approving or acceding to the International Convention against Doping in Sport and implementing it on its territory.

Anti-Doping Organizations

National Anti-Doping Organization (NADO) Entity designated by a country as possessing the primary authority and responsibility to adopt and implement anti-doping rules, as well as direct the collection of samples, the management of test results, and the conduct of hearings, all at the national level. If this designation has not been made by the competent public authority(ies), the entity will be the country's National Olympic Committee or its designee. Regional Anti-Doping Organization (RADO) Anti-Doping Organization established by a group of countries to coordinate, manage and deliver the mandate of doping-free sport within a specific region. WADA’s anti-doping development program aims at facilitating the creation of such entities in order to ensure implementation of anti-doping programs in all parts of the world.

World Anti-Doping Agency (WADA) Recognized by public authorities and by the Olympic Movement as the international body responsible for the fight against doping in sport and for the World Anti-Doping Code.

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Sport Organizations

International Olympic Committee (IOC)

Promotes Olympism and is responsible for the running of the Olympic Games in accordance with the Olympic Charter.

International Paralympic Committee (IPC)

The global governing body of the Paralympic Movement, promoting Paralympic values and responsible for organizing the Summer and Winter Paralympic Games.

International Federations (IFs)

Each recognized as the official world governing body for a particular sport. Each has the responsibility to perform doping controls, and manage therapeutic use exemptions and whereabouts programs for international Athletes in its registered testing pool.

National Federations (NFs)

Each recognized by the relevant IF as the official national governing body for its sport.

Court for Arbitration for Sport (CAS)

Independent institution responsible for facilitating the settlement of sports-related disputes and hearing appeals by parties (Athletes, Athlete support personnel, IFs, IOC, WADA, etc.) involved in international doping cases.

National Olympic Committees (NOCs)

Each recognized by the IOC as the official Olympic governing body in its country.

Other Organizations Responsible for Major Events Continental associations of National Olympic Committees and other international multi-sport organizations are responsible for adopting and implementing anti-doping policies and rules, which conform to the Code, for any of their respective events. Examples of such organizations include:

• Commonwealth Games (Commonwealth Games Federation - CGF) • Continental Games (Pan American Sports Organization – PASO; Association of

National Olympic Committees of Africa – ANOCA; European Olympic Committees – EOC; Oceania National Olympic Committees – ONOC; Olympic Council of Asia – OCA; Central-American and Caribbean Games Organization – ODECABE; South American Sport Organization - ODESUR)

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2.2 Overview of Anti-Doping © WADA – DCO Manual - Version 3.0 – May 2011

Overview of Doping Control Testing Testing on Athletes is carried out in accordance with the World Anti-Doping Code and the International Standard for Testing. Athletes who compete at the international and national level may be tested anytime, anywhere. Anti-Doping Organizations (ADOs) can conduct in-competition and out-of-competition tests on Athletes. Urine and blood samples may be collected and analyzed. In-competition testing is when an Athlete is selected for testing in connection with a specific competition (i.e. National Championships; Olympic Games; World Cup). Athletes are selected for testing based on the regulations of the relevant International Federation or event ruling body. These criteria may include place of finish (e.g. top 5 places in an event), random selection, or a target test. Out-of-competition testing is when an Athlete is tested outside of an event and can take place at any time and at any place, with no advance notice to the Athlete. This means that Athletes may be tested at their home, training locations, work place or anywhere else they can be found. ADOs decide when and where the Athlete will be tested. To allow for out-of-competition testing, some Athletes are required to provide accurate and current whereabouts information. This information includes details which will help a Doping Control Officer (DCO) find the Athlete on any given day such as a home address, work schedule, training venues and schedule, and competition schedule.

Samples are analyzed in a laboratory that is accredited by the World Anti-Doping Agency (WADA).

Prohibited List The List of Prohibited Substances and Methods (List), updated annually by WADA, is the International Standard defining what is prohibited in- and out-of-competition. The List also indicates whether particular substances are banned in particular sports. The most current edition of the List is posted on WADA's Web site at: http://www.wada-ama.org. Athletes may at times experience a medical condition that requires using particular medicines. The substances that an Athlete may be required to take to treat a condition could fall under the List. However, by applying and obtaining a therapeutic use exemption (TUE) in advance from their ADO, an Athlete may be allowed to take the necessary medicine.

Results Management An Athlete’s sample is divided into two, referred to as the A sample and a B sample. The laboratory that has analyzed the A sample will report the results simultaneously to the ADO responsible for results management and WADA. If there is an adverse analytical finding (AAF) on the A sample, the organization responsible for results management will conduct an initial review. If the initial review supports the AAF, the Athlete is notified in writing of the results and the rights regarding the analysis of his/her B sample. Should the B sample analysis confirm the A sample analysis, the responsible ADO will proceed with the results management process including the Athlete’s right to a fair hearing. The hearing will determine whether an anti-doping rule violation has occurred as well as

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determine what sanctions will be imposed. In the event that the B sample analysis does not confirm the A sample analysis no further action with the anti-doping rule violation will be taken. When an anti-doping rule violation is found, the ADO that authorized the sample collection is responsible for initiating the results management process. An independent panel will determine what sanctions will apply to each individual case and an Athlete will be given the opportunity to establish a basis for eliminating or reducing the sanction. Sanctions for violating anti-doping regulations may range from a warning to a lifetime ban. The period of ineligibility may vary depending on the type of anti-doping rule violation, the circumstances of an individual case, the substance, and the possible repetition of an anti-doping rule violation. For in-competition testing, this will automatically include disqualification of results obtained in that competition and forfeiture of any medals, points, and prizes. All results of any competitions following collection of the sample may also be disqualified.

Terminology / Definitions

ADAMS The Anti-Doping Administration and Management System (ADAMS) is a Web-based database management tool for data entry, storage, sharing and reporting information amongst relevant anti-doping organizations. Anti-Doping Organization (ADO) Organization that is responsible for adopting and executing rules for initiating, implementing or enforcing any part of the doping control process. This includes, for example, the International Olympic Committee, the International Paralympic Committee, other major event organizations that conduct testing at their events, the World Anti-Doping Agency, International Sport Federations, and National Anti-Doping Organizations. Athlete Whereabouts Information (Whereabouts) Information provided by or on behalf of an Athlete that details the Athlete’s location on a daily basis in order to enable unannounced, no advance notice, testing. Chain of Custody The sequence of individuals and/or organizations that have the responsibility for a sample from the provision of the sample until the sample has been received for analysis.

Chaperone Official who is trained and authorized by the anti-doping organization to carry out specific duties including one or more of the following: notification of the Athlete selected for sample collection, accompanying and observing the Athlete until arrival at the doping control station, and/or witnessing and verifying the provision of the sample where the training qualifies him/her to do so. Doping Control Process including test distribution planning, sample collection and handling, laboratory analysis, therapeutic use exemptions, results management, hearings and appeals. Doping Control Officer (DCO) Official who has been trained and authorized by the anti-doping organization with delegated responsibility for the on-site management of a sample collection session.

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Doping Control Station Secure location where the sample collection session is conducted. Missed Test A failure by the Athlete to be available for testing at the location and time specified in the 60-minute time slot identified in his/her Whereabouts Filing for the day in question. Sample Any biological material collected for the purposes of doping control. Sample Collection Session All of the sequential activities that directly involve the Athlete, from notification until the Athlete leaves the doping control station after having provided his/her sample/s. Sample Collection Personnel A collective term for qualified officials authorised by the ADO who may carry out or assist with duties during the sample collection session. Testing Authority The International Olympic Committee, the International Paralympic Committee, WADA, an International Federation, a National Sport Organization, a National Olympic Committee, a Major Event/Games Organization, a National Anti-Doping Organization or another authority responsible for sample collection and transport either in-competition or out-of-competition and/or for management of the test result. WADA Accredited Laboratory Anti-doping laboratory accredited by WADA in compliance with the International Standard for Laboratories.

Additional Resources

• About WADA Brochure –

http://www.wada-ama.org/rtecontent/document/About_WADA_en.pdf

• World Anti-Doping Code – http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/The-Code/

• International Standards – Prohibited List - http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/International-Standards/Prohibited-List/ Testing - http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/International-Standards/IST/ Laboratories - http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/International-Standards/International-Standard-for-Laboratories/ Therapeutic Use Exemptions – http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/International-Standards/International-Standard-for-Therapeutic-Use-Exemptions/

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Protection of Privacy and Personal Information – http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/International-Standards/International-Standard-for-the-Protection-of-Privacy-and-Personal-Information-/

• Models of Best Practice and Guidelines –

http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/Model-Rules--Guidelines/

• List of WADA accredited laboratories – http://www.wada-ama.org/en/Science-Medicine/Anti-Doping-Laboratories/

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3.1 DCO Roles and Responsibility © WADA – DCO Manual - Version 3.0 – May 2011

3.1 DCO Roles and Responsibilities

Purpose

The purpose of this section is to describe the roles and responsibilities of Doping Control Officers (DCOs) as well as to identify the code of conduct that DCOs must adhere to when performing their duties on behalf of the anti-doping organization (ADO).

Criteria for selecting DCOs DCOs should meet the following criteria: 1. At a minimum, be the legal age of majority in their country (i.e. not a Minor) Participate in an individual or small-group training session for initial certification 2. Demonstrate ability to communicate effectively in the national language(s). It is also

preferred that the DCO can communicate in English 3. Demonstrate ability to follow instructions 4. Demonstrate ability to work under demanding conditions 5. Demonstrate ability to quickly and effectively solve problems 6. Knowledge of the national and international sporting community 7. Ability to act in a respectful and professional demeanor 8. Ability to maintain confidential information 9. Ability to demonstrate sensitivity to Athlete emotions 10. Ability to meet schedule demands of required duties 11. Preferably possess a valid driver’s license and vehicle 12. Inform the ADO of any possible conflicts of interest, including involvement in the

administration of the sport for which testing is being conducted, or in the personal affairs of or relation to any Athlete that may undergo doping control

13. Ability and interest to train other sample collection personnel on doping control procedures

14. Ability and interest to educate Athletes on doping control procedures

DCO roles and responsibilities A DCO is an official who has been trained and authorized by the ADO with delegated responsibility for the on-site management of a sample collection session. The DCO is at the forefront of the ADO and plays an important role in protecting the rights of Athletes to compete in doping-free sport. • The DCOs are responsible for all steps in the sample collection session.

• During the results management process, the DCO’s management of the sample collection session may be reviewed. Therefore it is important that the procedures are completed correctly in order to avoid a result being overturned.

• DCOs must ensure that any incidents that could compromise the sample collection session are documented and the ADO is informed immediately.

• If a DCO is asked to provide testimony in a hearing, he/she must ask themselves: - Can I recall the testing mission?

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- Can I defend my procedures conducted and decisions made during the testing mission?

An important message for DCOs to remember:

Document what you do and do what you document! Code of Conduct

DCOs must demonstrate professional and courteous behavior when representing the ADO at sample collection sessions.

DCOs must not:

• Speak to the media at anytime on behalf of the ADO or concerning the doping control process

• Ask Athletes for their autograph • Request photographs of Athletes • Request food or beverages at the event • Enter areas of the venue not accredited to sample collection personnel • Gamble on the outcome of a sporting event they are present at • Request any memorabilia from the event e.g. clothing • Accept gifts from an Athlete or sport official • Keep personal files of test data • Divulge confidential data to third parties • Over familiarization with Athletes (e.g. attend an Athlete’s weddings) • Drink alcohol at events • Wear clothing that makes an association with a National Federation or International

Federation or other organization related to the sport while performing sample collection activities

• Give ADO equipment or documentation to a third party without permission

DCOs must:

• Report all potential conflicts of interest • Report any irregularities during a testing session

DCOs must understand that their presence at a sample collection session is a privileged position and that this authority must not be abused. If a gift is offered to a DCO this must be declared with the ADO.

Behaviors and best practices that should be demonstrated by DCOs include:

• Courteous and professional approach at all times • Sensitivity to the requirements placed on an Athlete during doping control • Checking the understanding of an Athlete throughout the process, offering

explanations where appropriate • Appropriate clothing and appearance for the event • Always arrive on time • Adhere to procedures contained in the DCO Manual and the ADO-DCO Agreement

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DCO Accreditation An ADO is responsible for the accreditation (and re-accreditation) of DCOs. Accredited DCOs will be provided with authorization documentation by the ADO that identifies the DCO by name (e.g. accreditation card). DCOs will be evaluated on a continuous basis to ensure the highest standard of quality. A DCO’s accreditation is valid for a fixed term as determined by the ADO. The ADO may revoke a DCO’s accreditation at anytime.

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3.2 Anti-Doping Organization/ DCO Agreement (sample) © WADA – DCO Manual - Version 3.0 – May 2011

3.2 Anti-Doping Organization/Doping Control Officer Agreement (sample)

This agreement is entered into between the Anti-Doping Organization (ADO) and ___________________

, a volunteer serving the ADO at its discretion as an ADO Doping Control Officer (DCO). In consideration of the payment for services by the ADO and the covenants herein contained and other goods and valuables consideration the DCO agrees as follows:

1.

Relationship

I understand that I am not an employee of the ADO. My relationship with the ADO is as a volunteer. I agree not to represent myself as a DCO or purport to represent the ADO unless authorized to do so by the ADO. I understand that I will not receive any other benefits outside of the compensation and reimbursement for expenses specified for my services. 2.

Term

I understand that the use of my services as a DCO is at the sole discretion of the ADO. I acknowledge that my accreditation as a DCO for the ADO is issued at the sole discretion of the ADO and may be revoked at any time for cause or no cause by the ADO. I will return my DCO credentials and any other ADO property (sample collection equipment, manual, etc.) to the ADO immediately upon request by the ADO. 3.

Confidentiality

I understand as an ADO DCO that the ADO will disclose to me sensitive and confidential information necessary for the performance of my duties. I agree to keep any such information strictly confidential and will only disclose such information at the request of or with permission from the ADO, or when legally compelled to do so. This confidential information may include but is not limited to: Athlete names, Athlete residence and training addresses, Athlete telephone numbers, Athlete testing information and Athlete test result information. 4.

Conflict of Interest

I understand that while representing the ADO, I assume an obligation to subordinate my individual interests to the interests of the ADO and its mission. I have read and understand the ADO Statement of Principles on Ethical Behavior and Conflict of Interest attached to this Agreement as ANNEX A. I will complete and return to the ADO the ADO Conflict of Interest Disclosure Statement attached to this Agreement as ANNEX B

. I pledge my full support of the spirit and letter of the requirements as applicable to my duties as a DCO. I agree to serve the ADO without an interest in personal gain, to avoid any institutional loss or embarrassment to the ADO and to behave in such a way that the ADO’s trust and public confidence are enhanced. I will avoid any real or apparent conflict of interest in my role as a DCO for the ADO.

5.

Duties

I AGREE to use my best efforts in all duties directly or indirectly relating to my role as an ADO DCO. I agree to use my best efforts in complying with the ADO’s protocol and procedures. I agree to ensure that the ownership, security and chain of custody of samples are maintained at all times.

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3.2 Anti-Doping Organization/ DCO Agreement (sample) © WADA – DCO Manual - Version 3.0 – May 2011

I AGREE to maintain the highest standard of professional and personal conduct in all activities associated with the ADO. While my primary duties involve sample collection, other functions may include: testimony at hearings, educational presentations and other activities whereby I will be representing the ADO at the ADO’s request. I agree to refrain from soliciting autographs, photographs, gifts or souvenirs from any Athlete, coach or official when representing the ADO. I AGREE to refrain from discussing issues outside of my role as a DCO, such as medical advice, ADO policies, or confidential information regarding Athletes tested, with Athletes or their support personnel. I AGREE to maintain a professional appearance and demeanor while conducting the ADO activities or while representing the ADO. I AGREE to ensure my DCO credentials are kept current as long as I am an active ADO DCO, and that a photo will be on file with the ADO for such uses as accrediting or providing identification as needed to an outside entity where I may conduct testing. I AGREE to not participate in any doping control involving Sample Collection outside of the ADO, unless granted permission by the ADO. 6.

Miscellaneous

Any dispute not otherwise resolved by the parties arising out of or related to this Doping Control Officer Agreement shall be resolved through non-binding, good-faith mediation. In the event the mediation is unsuccessful, the parties agree to resolve the dispute in binding arbitration before an agreed upon dispute panel, or if not available, the Court of Arbitration for Sport. This Agreement is intended solely for the benefit of the ADO and DCO. No other party shall be entitled to claim in any way that it is a third party beneficiary of this Agreement. Please print and sign your name and date this document in the spaces provided indicating that you have read and agree to the ADO Doping Control Officer Agreement. The original will be kept in the ADO offices. A signed copy of this document will be mailed to you. Printed DCO Name: ADO Representative DCO Signature: Date: Date:

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3.2 Anti-Doping Organization/ DCO Agreement (sample) © WADA – DCO Manual - Version 3.0 – May 2011

ANNEX A

ADO DOPING CONTROL OFFICER AGREEMENT

STATEMENT OF PRINCIPLES ON ETHICAL BEHAVIOR AND CONFLICT OF INTEREST

Those who choose to serve the Anti-Doping Organization (ADO), whether as volunteers or paid professionals, are held to the highest standards of conduct. As guardians of the ideals of sport, they assume an obligation to subordinate individual interests to the interests of the ADO and its mission.

Those who serve the ADO must do so without personal gain, to avoid any institutional loss or embarrassment and to behave in such a way that the organization's trust and public confidence are enhanced. It is important to avoid any real conflict of interest as well as to avoid even the appearance of a conflict of interest.

It is important to keep in mind that the principles which guide behavior in this area are disclosure, physical absence and non-participation in the decision making process where personal or family gain is a possibility, and a commitment to honor the confidentiality of organizational information. This means you must (i) disclose conflicting interests when they arise, (ii) remain absent from the evaluation process, (iii) not participate in, or be present at, any decision-making process relating to the matter in question, and (iv) maintain the confidentiality of ADO deliberations and information. All conduct is founded on the individual's own sense of integrity. Any individual accepting the honor of serving the ADO must also accept the burdens of public disclosure and public scrutiny.

The following guidelines are considered minimum standards in service to the ADO. Each individual's values undoubtedly lead to additional, self-imposed guidelines:

1. The business of the ADO is to be conducted in observance of both the spirit and letter of applicable local laws.

2. Properties, services, opportunities, authority, and influence of the ADO are not to be used for private benefit.

3. All ADO Doping Control Officers will be required to complete a conflict of interest form. All such individuals will make full disclosure of the nature and extent of any actual or potential conflict of interest. In the consideration of an issue, where possible conflicts exist, such individuals will avoid evaluating, or in any other way influencing, directly or indirectly, or voting on the matter involved, and will be physically absent during the evaluation and vote. No DCO or any immediate family member of a DCO shall:

a. Serve in any capacity, paid or unpaid, for a National Sport Federation (NSF) in a sport in which the DCO conducts testing for the ADO;

b. Have a business or commercial relationship with an NSF in a sport in which the DCO conducts testing for the ADO;

c. A Doping Control Officer shall not accept gifts, souvenirs, cash, travel, hotel accommodations, entertainment or favors from an NSF in a sport in which the DCO conducts testing for the ADO.

4. An immediate family member under this Paragraph 4 is defined as any spouse, parent, sibling or child of the DCO.

5. Expenses incurred in the furtherance of the ADO business are to be reasonable, necessary and substantiated, in accordance with the ADO Payment Structure.

6. All are expected to respect honesty, loyalty, candor and professional competence in their relationships with the ADO and with each other.

7. Each individual has the responsibility to maintain the confidentiality of the ADO information. This includes both proprietary and sensitive information.

8. Each individual agrees not to use tobacco in or around a doping control station or to consume alcohol beverages while acting as a representative of the ADO.

9. Each individual agrees not to gamble or bet to any extent, on any event in which they are acting as a representative of the ADO.

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3.2 Anti-Doping Organization/ DCO Agreement (sample) © WADA – DCO Manual - Version 3.0 – May 2011

ANNEX B

ADO DOPING CONTROL OFFICER AGREEMENT

CONFLICT OF INTEREST DISCLOSURE STATEMENT

(Use additional sheets if necessary) 1. If you or any member of your immediate family is an officer, director, employee, member,

volunteer of the National Olympic Committee (NOC), a National Sport Federation (NSF) or an International Federation (IF), please list the name and address of the entity(ies), the nature of your relationship with entity(ies), and describe the dealings. If none, please state none.

2. If you have reason to believe that you or any immediate members of your family may be

affiliated or have business dealings with the NOC, a NSF or an IF, in the future, please list those entities and the nature of such dealings. If none, please state none.

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3.2 Anti-Doping Organization/ DCO Agreement (sample) © WADA – DCO Manual - Version 3.0 – May 2011

3. If there is any relationship or matter not disclosed above which might be perceived to compromise your obligations to the ADO under the ADO's Statement of Principles or which may raise questions of a conflict between your duty and loyalty to the ADO and your economic self-interest, please indicate here what that relationship or matter is. This could also include any relationship with an Athlete, a member of the Athlete’s family, or a coach. If none, please state none.

Print DCO Name _____________________ DCO Signature Date

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3.3 Recruiting and Training Chaperones © WADA – DCO Manual - Version 3.0 – May 2011

3.3 Recruiting and Training Chaperones

Purpose

The purpose of this procedure is to provide instruction to the DCO on how to recruit and train Chaperones in order to ensure the notification and witnessing procedures are carried out correctly. This procedure also identifies the code of conduct that Chaperones must adhere to when performing their duties on behalf of the Anti-Doping Organization (ADO).

Actions

Recruiting Chaperones

When recruiting people to act as Chaperones for doping control, the DCO is responsible for ensuring that the Chaperones meet the following criteria:

1. Is not a Minor. 2. Meet the gender requirements for the specific sample collection session 3. Ability to communicate effectively in the national language(s) and, if required the

language of the Athletes to be tested and/or English 4. Physically fit and active 5. Ability to follow instructions 6. Ability to work under demanding conditions 7. Ability to quickly and effectively solve problems 8. Act in a respectful and professional demeanor 9. Ability to maintain confidential information 10. Ability to demonstrate sensitivity to Athlete emotions 11. Ability to meet schedule demands of required duties 12. No involvement in the administration of the sport for which testing is being conducted 13. No involvement in the personal affairs of or relation to any Athlete that may undergo

doping control 14. Completion of training related to doping control responsibilities 15. Completion of Chaperone Responsibilities Form

, as appropriate

Training Chaperones

1. The DCO should meet with the Chaperones prior to the start of the sample collection session to provide training, instruction, credentials and assignments, as well as to ensure that the Chaperones meet the criteria listed on the Chaperone Responsibilities Form and that the form is completed (See reference 3.4)

. The DCO will determine how much time is needed to conduct a thorough training session and arrange an appropriate meeting time and place. The DCO must print/sign his/her name, date, and provide the event name on each form and submit these forms along with other sample collection documentation to the ADO.

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3.3 Recruiting and Training Chaperones © WADA – DCO Manual - Version 3.0 – May 2011

NOTE: If conducting no-notice testing this training should be away from the venue where the testing will take place. If conducting announced in-competition testing, the event organizer may be responsible for providing the Chaperones. If conducting unannounced

testing (in-competition or out-of-competition) then the DCO will be responsible for providing Chaperones. The DCO should check with the ADO whether Chaperones will be provided.

2. The DCO must ensure that all Chaperones are fit for duty upon their arrival at the doping control station and that they meet the selection criteria for Chaperones (See reference 3.3). If a DCO does not believe a Chaperone is able to perform his/her duties in a professional manner, he/she should ask the Chaperone to leave the doping control station.

3. The DCO should specifically ask the Chaperones if they have any involvement in the

administration of the sport being tested or if they have any involvement in the personal affairs of, or relation to, any Athlete who might be tested. If a Chaperone is determined to have a potential or existing conflict of interest, the DCO should not use these individuals, if at all possible. The DCO should, however, proceed with the training of these individuals if no other Chaperones can be secured, however these Chaperones will not be permitted to witness the passing of the sample. If it is necessary to utilize these individuals, this should be noted on the Doping Control Officer Report Form

, and the Chaperone should be assigned to an Athlete who is as far removed from the conflict as possible (e.g., opposite gender, different discipline, etc.).

NOTE: The following should be considered when determining potential or existing conflicts of interest: • The individual should not serve in any capacity, paid or unpaid, for a National Sport

Federation (NSF), the National Olympic Committee (NOC)

• The individual should not have a business or commercial relationship with an NSF, and IF or the NOC or other organization related to the sport;

or an International Federation;

• The individual should not accept gifts, cash, travel, hotel accommodations, entertainment or favors from the NOC, an NSF, and IF or any other NOC-member organization, sport or event official, or any Athlete subject to testing by the ADO

(See reference 3.3, 3.4).

4. The DCO should ensure that all Chaperones have a watch in order to determine and record the time of notification.

5. Whenever possible, the DCO should try to assign Chaperones to Athletes of their same gender for notification.

6. The DCO should include scenarios that the Chaperones may encounter. The DCO should then brief the Chaperones on the best solution for each of these scenarios. The DCO should also stress that whenever a Chaperone does not know what to do or if he/she observed unusual behavior by an Athlete, he/she should find the DCO as soon as practical, without leaving the Athlete or his/her sample unattended (unless the Athlete is refusing to accept notification or evade the notification).

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3.3 Recruiting and Training Chaperones © WADA – DCO Manual - Version 3.0 – May 2011

Notification To effectively train Chaperones on Athlete notification, use a general three-step approach: Explain, Show, and Practice.

EXPLAIN: The DCO should thoroughly review the specifics of the Athlete notification procedure (see reference 5.1) and maintaining contact with the Athlete after notification as documented on the Chaperone Responsibilities Form

. The orientation should provide Chaperones with a detailed explanation of the purpose of their job, and what they should do if they encounter any problems when notifying Athletes. The DCO should also stress that whenever a Chaperone does not know what to do, he/she should find the DCO as soon as practical, without leaving the Athlete unchaperoned.

SHOW: Demonstrate what notifying an Athlete should look like. Utilize another member of the sample collection personnel to show Chaperones what they should do and say. Providing Chaperones with the actual words to use will aid them in approaching and notifying their Athletes. Also it is important that the Chaperones are shown around the venue so that they can orientate themselves and are aware of the following:

• The field of play in relation to the doping control station • Areas suitable to complete verbal and written notification • The route to the doping control station and any potential public areas • General logistics including mixed zones and locations where medal ceremonies are to

take place

PRACTICE: Allow each Chaperone to practice the notification process. It may be useful to have one Chaperone practice notifying the other and then switch. Each Chaperone should practice at least once in the presence of the DCO, so that the DCO can point out any mistakes, as well as praise areas that a Chaperone did well. Utilize other DCOs to assist with this step and be sure to allow enough time for Chaperones to practice. The DCO should ask the Chaperones if they have any questions about the process.

Witnessing The DCO should review, in detail, the specific information on the Chaperone Responsibilities Form (see reference 3.4) and the urine sample collection procedure (reference 6.1). These specifics include the direct, unobstructed observation of the urine passing from the Athlete to the collection vessel. The DCO should also remind the Chaperone of the requirement to sign his/her name on the Doping Control Form, to verify that the Athlete provided the sample and that a clear, unobstructed view was maintained

.

NOTE: The Chaperone must not sign the Doping Control Form

unless he/she is satisfied that he/she saw the sample being passed from the Athlete to the collection vessel.

Chaperones should also be briefed about any appropriate sensitivities, special testing circumstances, and any possible conflicts of interest or other concerns.

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3.3 Recruiting and Training Chaperones © WADA – DCO Manual - Version 3.0 – May 2011

Chaperone Conduct

Chaperones must demonstrate professional and courteous behavior when representing the ADO at sample collection sessions. Chaperones must not:

• Speak to the media at anytime • Ask Athletes for autographs • Request photographs of Athletes • Request food or beverages at the event • Enter areas of the venue not accredited to sample collection personnel • Gamble on the outcome of a sporting event they are present at • Request any memorabilia from the event (e.g. clothing) • Accept gifts from an Athlete or sport official • Keep personal files of test data • Divulge confidential data to third parties • Over familiarization with Athletes (e.g. attend an Athlete’s wedding) • Drink alcohol at events • Wear clothing that makes an association with a National Federation, International

Federation or other organization related to the sport while performing sample collection activities

• Give ADO equipment or documentation to a third party without permission

Chaperones must: • Report all potential conflicts of interest • Report any irregularities at a testing session

Chaperones must understand that their presence at a sample collection session is a privileged position and that this authority must not be abused. If a gift is offered to a Chaperone this must be declared with the ADO through the DCO.

Behaviors and best practice that should be demonstrated by Chaperones include:

• Courteous and professional approach at all times • Sensitivity to the requirements placed on an Athlete during doping control • Checking the understanding of an Athlete throughout the process, offering

explanations where appropriate • Appropriate clothing and appearance for the event • Always arriving on time • Adhering to procedures outlined by the DCO and ADO

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3.4 Chaperone Responsibilities/ Code of Conduct Form © WADA – DCO Manual - Version 3.0 – May 2011

3.4 Chaperone Responsibilities/Code of Conduct Form

All ADO Chaperones Must Meet The Following Criteria:

• Not a Minor • Ability to communicate effectively in the national language(s), and if required the

language of the Athletes to be tested and/or English • No involvement in the administration of the sport for which testing is being conducted • No involvement in the personal affairs of or relation to any Athlete that may undergo

doping control • Ability to walk for extended distances

All ADO Chaperones Must Possess The Following Characteristics:

• Ability to follow instructions • Ability to work under demanding conditions • Ability to quickly and effectively solve problems • Ability to demonstrate respectful and professional demeanor • Ability to maintain confidential information • Ability to demonstrate sensitivity to Athlete emotions • Ability to meet schedule demands of required duties

Athlete Notification

• The Chaperone will be provided with a Doping Control Form indicating the Athlete selection information.

• The information regarding Athlete selection or competition and position should remain confidential unless an event official (for in-competition testing) has been requested to assist with identifying the appropriate Athlete and/or finishing position.

• At the appropriate time as indicated by the DCO, the Chaperone will approach the Athlete and notify the Athlete of his/her selection for doping control and under what authority the sample collection is to be conducted. NOTE: When testing an Athlete who is considered a Minor or an Athlete with a disability, consideration should be made for notifying a third party, when possible.

• The Chaperone will be responsible for informing the Athlete that he/she: 1. Must arrive at the designated doping control station immediately following

notification; 2. Is allowed to bring one (1) accompanying representative and, if necessary, an

interpreter to the doping control station; 3. Will be accompanied by the Chaperone until the completion of the sample

collection process; 4. Should bring photo identification to the doping control station; and 5. The possible consequences of a failure to comply.

• In the appropriate sections of the Doping Control Form, the Chaperone will print and sign his/her name.

• The Chaperone and/or DCO will confirm the Athlete's identity. The Chaperone will request that the Athlete read and sign the Doping Control Form in the notification section, acknowledging his/her selection for doping control and understanding his/her rights and responsibilities as presented on the relevant ADO documentation (i.e. Doping Control Form).

• The Chaperone will report any unusual behavior to the DCO or his/her designee as soon as possible.

• The Chaperone will immediately report to the DCO any Athlete’s failure to comply with a request for doping control.

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3.4 Chaperone Responsibilities/ Code of Conduct Form © WADA – DCO Manual - Version 3.0 – May 2011

Maintaining Contact with the Athlete After Notification

• The Chaperone must remain with the Athlete until he/she arrives and has completed the doping control procedures or another DCO/Chaperone has accepted responsibility for the Athlete. The Chaperone should stay as close in proximity to the Athlete as possible and must maintain visual contact with the Athlete at all times until the Athlete reports to the doping control station.

• The Chaperone should ensure that the Athlete reports to the doping control station immediately following notification. If the Athlete requests a delay in reporting to the doping control station, the Chaperone/DCO may grant this delay. If the Athlete cannot be continuously chaperoned the Chaperone/DCO may reject this request.

• The Chaperone may permit the Athlete to participate in a victory ceremony, fulfill media commitments, compete in further competitions, perform a warm down, obtain necessary medical treatment, locate a representative and/or an interpreter, obtain photo identification and any other exceptional circumstances that might be justified.

• The Chaperone should ensure that the Athlete does not leave the competition venue and that the Athlete does not urinate until they go through the doping control process.

• If the situation allows, the Chaperone may direct the Athlete to a selection of individually sealed beverages from which to choose. The Chaperone should not select the Athlete’s beverage or, once selected, handle the Athlete’s beverage.

• If the Chaperone observes any suspicious or unusual behavior exhibited by the Athlete, the Chaperone will report this to the DCO or his/her designee as soon as possible.

Witnessing Sample Collection

• Chaperones with the responsibility of observing Athletes providing urine samples must be the same gender as the Athlete and must carry out the witnessing in a mature and responsible manner.

• Only the designated Chaperone and Athlete should be in the restroom during the sample collection procedure, unless otherwise directed by the DCO.

• If the Athlete is a Minor or has a disability, the Chaperone will be informed by the DCO if special procedures are to be followed for the sample collection procedure.

• The Chaperone will request the Athlete to provide a clear view of the middle of the Athlete’s body, hands and forearms to ensure an unobstructed view of the passing of the Sample. This should include the Athlete’s shirt being pulled up to mid-torso, sleeves rolled up to the elbows, and trousers down to mid-thigh.

• The Chaperone will present the Athlete with techniques to ensure that the direct, unobstructed observation of the urine passing from the Athlete into the collection container is accomplished.

• The Chaperone will request the Athlete to wash his/her hands prior to the provision of the sample.

• After observing the passing of the sample and when requested by the DCO, the Chaperone will print and sign his/her name on the Doping Control Form in the appropriate area to confirm that he/she had a direct, unobstructed view of the passing of the Sample.

• The Chaperone should report to the DCO any suspicious or unusual behavior exhibited by the Athlete.

Code of Conduct

As an ADO-authorized Chaperone, I am aware of and will perform my assigned responsibilities in the manner outlined in this document. I therefore agree: • To arrive on time at the appointed location • To maintain the highest standard of personal conduct in all assigned duties as a

Chaperone • Not to accept any gifts from Athletes or their representatives • Not to request photographs or autographs from any Athlete or individual while

conducting ADO business or wearing ADO attire • To strive to be cooperative and courteous with individuals and to use good judgment

when performing all duties as a Chaperone • To maintain a professional appearance while carrying out my duties as a Chaperone.

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3.4 Chaperone Responsibilities/ Code of Conduct Form © WADA – DCO Manual - Version 3.0 – May 2011

I have read and understood the Chaperone Responsibilities Form. I do affirm that in the performance of my duties as a Chaperone for the ADO, I will observe and comply with this agreement and the ADO policies contained herein. _________________________________________________________________________________________________________ Chaperone Printed Name Signature Date __________________________________________________________________________________________________________ Street Address City/State/Postal Code Telephone

CHAPERONE DATE OF BIRTH:

GENDER: MALE FEMALE Month Day Year

To Be Completed By the Doping Control Officer I have verified that the Chaperone named on this form is not a Minor. This Chaperone was properly trained and was authorized to assist with the doping control process in accordance with the ADO’s Procedure for Training Chaperones at the following test:

EVENT NAME: _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ Lead DCO Printed Name Signature Date

The ADO promotes a healthy, doping-free sporting environment. Therefore, use of tobacco in or around the testing area or near Athletes is not allowed. Tobacco use should be done outside of time performing Chaperone duties and out of ADO attire. Many sport organizations and venues embrace a smoke-free policy. Chaperones are expected to respect these policies at all times.

Chaperones shall not consume alcohol before or during their ADO responsibilities. Chaperones shall not attend any ADO-related activity under the influence of alcohol or other drugs. Drinking alcohol while wearing ADO attire is not permitted.

Chaperones are not permitted to place bets on any event that they have been requested to attend or at which they will be conducting testing activities on behalf of the ADO.

Tobacco, Alcohol and Gambling Policy

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4.1 Authorization and Preparation for Testing © WADA – Version 3.0 – May 2011

4.1 Authorization & Preparation for Testing

Purpose

The purpose of this procedure is to outline how a DCO will be authorized to conduct testing on behalf of the ADO as well as to describe the process for ensuring that all preparations are in place to conduct the sample collection session.

Actions

Authorization for Testing

The ADO will identify opportunities for testing out-of-competition or at in-competition events which require doping control. The DCO will be initially contacted by the ADO to obtain their availability to make sample collection attempts over a specific period or on a specific day. The ADO will then arrange for the following to be distributed to the DCO: • Mission Order - including the Mission Order Number (if applicable), venue for in-

competition testing, site contacts for in-competition testing, Athlete whereabouts for out–of-competition testing, the laboratory the samples are to be sent to for analysis and any other information relevant to the sample collection session.

• Letter of authority from the ADO permitting the DCO and their selected Chaperones to attend the event or make an attempt to locate the Athlete.

NOTE: DCOs should be reminded that they must have a piece of photo identification, in addition to the letter of authority, with them at all times during a sample collection session.

• Any necessary accreditation or event passes, car park passes or special instructions relevant to the testing mission.

Before Accepting a Test Mission Before accepting a testing mission the DCO must ensure the following: • That he/she has sufficient equipment and documentation or are able to obtain the

required documentation and equipment prior to the testing session. • That he/she is available for the whole day if a single day is identified, considering travel

times and the fact that the mission may have a late finish time.

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4.1 Authorization and Preparation for Testing © WADA – Version 3.0 – May 2011

• That he/she is able to test within the testing window identified by the ADO for an out-of- competition test.

NOTE: Attempts must not be made outside of the test window unless approved by the ADO.

• That sufficient and appropriate Chaperones are available to meet the number of tests requested.

The DCO will review all information relevant to the testing session in order to prepare properly. This will include reviewing the Athlete’s whereabouts, special instructions from the ADO, letter of authorization, courier requirements, etc. The authorization letter for doping control shall include the following information: • The test mission code (if applicable) • Date range of the testing mission • Signed by the ADO

• If the DCO does not have an official accreditation ID card provided by the ADO, the authorization should also include the DCO(s) name

NOTE: In addition to the authorization letter from the ADO, the DCO must have a piece of photo identification with them at all times during sample collection sessions.

The DCO will review equipment requirements to conduct the sample collection session. Suggested equipment requirements: • Sample collection vessels: 3 x # of tests

• Sample collection kits: 3 x # of tests

• Partial sample kits: 1.5 x # of tests

• Reagent strips (Labstix) or refractometer

• Courier transport bags: adequate supply based on capacity of bags and # of tests

• Courier transport bag seals: 3 x # of bags

• Sealed beverages: 3 x # of tests

Suggested doping control documentation requirements: • Doping Control Forms: 3 x # of tests

• Chain of Custody Forms: 2 x # of bags

• Supplementary Report Forms: 1.5 x # of tests

• DCO Report Forms: adequate supply

• Unsuccessful Attempt Report Form: adequate supply

The DCO shall always ensure that there is a choice of at least three (3) sample collection kits, sample collection vessels and partial sample kits for the Athlete to select from. If the doping control equipment and administration forms do not meet the specifications as listed above, the DCO shall report it to the ADO who shall arrange for the relevant equipment and forms to be provided. The DCO should also ensure that he/she has adequate sample collection personnel available for the mission.

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4.1 Authorization and Preparation for Testing © WADA – Version 3.0 – May 2011

Upon receipt of the documentation from the ADO, the DCO must check all the details provided so that they are clear and understand what is required of them. Should there be any issues the DCO must contact the ADO to ensure they understand the request of the mission order.

NOTE: DCOs should be aware that each International Federation may have their own requirements regarding sample collection. This information will be provided to the DCO by the ADO on the mission order.

Arrival at sample collection site In-Competition Testing

NOTE: In-competition testing may or may not be conducted with the prior knowledge of the event organizer.

For in-competition testing, the DCO should make contact with the event organizer upon arrival and conduct a walk through of the competition site and doping control station. The DCO will assess: • The location of the doping control station in relation to the competition site • The ideal location for Athlete notification • Appropriateness of facilities for the doping control station The DCO will ensure he/she has enough sample collection personnel to conduct the sample collection session and will brief/train the sample collection personnel on their roles and responsibilities during the sample collection session. Out-of-Competition Testing For out-of-competition testing, the DCO should review the Athlete whereabouts information provided by the ADO to ensure when and where the Athlete can be reached for testing. Upon arrival at the testing venue, the DCO should do a visual inspection of the venue to determine: • The ideal location for Athlete notification • Appropriateness of facilities for the doping control station

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4.2 Doping Control Stations © WADA – DCO Manual - Version 3.0 – May 2011

4.2 Doping Control Stations

Purpose

The purpose of this procedure is to describe the process for ensuring that a suitable doping control station is used for in-competition testing and out-of-competition testing.

Actions In-Competition Testing

1. Where possible, the DCO should check the venue to determine whether a suitable

doping control station (DCS)

is available prior to the sample collection session.

Facilities should meet the following criteria for in-competition testing

:

General • Solely reserved for doping control purposes • Accessible only to authorized personnel • Secure enough to store sample collection equipment • Private enough to maintain Athlete privacy and confidentiality • Ideally comprised of a separate waiting room, processing room, and an appropriate

number of toilets. See diagram below. • Ensures that the health and safety of the Athlete and sample collection personnel are

not compromised • Large enough to accommodate the number of Athletes to be tested, athlete

representatives• Proximity to competition venue, or appropriate transportation plan

and sample collection personnel who will occupy the area

• Wash basin for Athletes and DCOs to wash their hands

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4.2 Doping Control Stations © WADA – DCO Manual - Version 3.0 – May 2011

Equipment - (per processing station)

• One table for every DCO processing documentation • Two chairs per Athlete being tested and one chair for each member of the sample

collection personnel • If necessary, access to dividers to ensure privacy and division of processing areas • Appropriate lighting to conduct processing • Receptacles for each processing station to store waste generated

Special • If necessary, wheelchair accessibility • If requested, security person outside doping control station • Educational materials or entertainment equipment (i.e., television, radio) for Athletes

in the waiting area • Additional equipment may be requested to accommodate special testing needs, i.e.

blood collections 2. The designated doping control station, including toilets, may not be used as a

public facility, office, team locker room, or shared with any event operation during the testing session.

3. If the DCO has determined that the facility is not appropriate, he/she should consult

whomever necessary, to obtain a suitable area and note this problem on the Doping Control Officer Report Form as well as how the problem was resolved.

4. If there is no suitable area within the proximity of the competition venue and the DCO

feels that the sample collection session would be compromised by using the proposed facility, the DCO must contact the ADO for advice on how to proceed. The DCO should not, without consultation and approval of ADO, cancel the in-competition testing session. The DCO should document the deficiencies of the designated doping control station

on the Doping Control Officer Report Form.

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4.2 Doping Control Stations © WADA – DCO Manual - Version 3.0 – May 2011

NOTE: ADO reserves the right in its sole discretion to cancel an in-competition testing session if, in its opinion, the facilities designated for the doping control station are such that the integrity of the sample collection session might be compromised.

Out-of-Competition Testing

1. For out-of-competition testing

(OOC), DCOs will be required to test Athletes outside of a competition period. This testing may occur at the Athlete’s residence, training venue or any other location where the Athlete may be found. If testing at a training venue, the DCO should identify a suitable area to act as the doping control station. If testing at the Athlete’s home, the Athlete should identify an area that meets the following criteria:

• Private enough to maintain Athlete privacy and confidentiality • Sufficient control over access to the area by other individuals who may be in the

Athlete’s home • Sufficient area to complete the required sample collection documentation and

process the sample(s) • Ensures that the health and safety of the Athlete and sample collection personnel are

not compromised • Ensures that wherever the Athlete may go, that the DCO and Chaperone can

maintain sight of them at all times

2. If there are any significant deviations from these criteria, the DCO should make a record of this in the Doping Control Officer Report Form.

3. If at all possible, Athletes should be tested where they are notified for OOC Testing, for

example, if the Athlete is notified at his/her training venue, he/she should be processed at the training venue. Occasionally, a DCO will encounter a situation that will require him/her to relocate the testing area. This will require that the DCO, Chaperone (if applicable) and the Athlete physically move (via automobile or other means) to another location with a suitable area for testing. Some examples include: • Training facility is closing and the testing area is no longer available • The Athlete has a previously planned activity (school, work, etc.) that he/she must

attend and cannot remain at the location where he/she was notified for testing • There is no suitable area in the Athlete’s residence to perform the test • The DCO does not feel safe in the Athlete’s residence • The Athlete requests that the testing take place in another location

If this situation occurs, the Athlete must be accompanied by the DCO or Chaperone at all times.

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4.2 Doping Control Stations © WADA – DCO Manual - Version 3.0 – May 2011

Access to Doping Control Station

1. The following individuals are authorized to be present at the doping control station:

a. On duty Doping Control Officer(s) b. c. Other Sample Collection Personnel on duty

On duty Chaperone(s)

d. Athletes being tested e. f.

Athlete Representatives

g. Interpreters Relevant representatives from relevant National Sport Federation, International Federation, and

h. ADO staff Event Representatives

i. Other individuals authorized by

ADO (e.g. auditors, independent observers, etc.)

2. The DCO has authority to prohibit anyone otherwise entitled entry to the doping control station if their presence is deemed by the DCO to be disruptive or interfering with the sample collection session.

3. Members of the media should never

be allowed to enter the doping control station at any time.

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4.2 Doping Control Stations © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist The DCO should consider the following questions when identifying a suitable doping control station.

Is the area identified private and available for the sole use of doping control?

Is the space identified appropriate for the number of individuals who may be present? Remember: the Athlete may be accompanied by a Representative

Are there sufficient chairs and tables for the number of samples to be processed?

Can the room be arranged so that the waiting area and processing area are separate (in-competition)?

Is there a wash basin for Athletes and DCOs to wash their hands?

Is there suitable storage space for partial samples, completed samples and documentation?

If applicable, are there suitable facilities for Athletes with a disability (e.g. ramps, disabled toilets etc.)?

Is the facility secure e.g. lockable or with an individual available to act as security?

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5.1 Athlete Notification Procedure © WADA – DCO Manual - Version 3.0 – May 2011

5.1 Athlete Notification Procedure

Purpose

The purpose of this procedure is to describe the process for notifying Athletes of their selection for doping control.

Actions

1. Notification of an Athlete’s selection for doping control should occur as soon as possible either upon arrival at the venue for an out-of-competition test or after an Athlete finishes their competition. The Chaperone

should attempt to notify the Athlete discretely (i.e. in private, away from public areas). The DCO may act as the Chaperone for notification and/or witnessing.

NOTE: The Anti-Doping Organization (ADO) has the authority to modify notification procedures as needed. For example, special notification procedures may be applied if the Athlete is a minor (as defined by the ADO), disabled, unable to speak the national language or for some other reason unable to receive and understand a request. The DCO

will review possible modifications prior to the start of the testing session.

NOTE: When testing an Athlete who is a minor or an Athlete with a disability, consideration should be made for notifying a third party, when possible. (See reference 6.7, 6.8)

2. The Chaperone should: • Identify him/herself to the Athlete as a Chaperone for doping control and show

identification and authorization for testing • Advise the Athlete that he/she has been selected to provide a Sample for doping

control • Complete the Notification Section of the Doping Control Form as instructed by the

• Ask the Athlete to read and sign the Notification Section of the DCO

Doping Control Form

• Inform the Athlete that he/she should report to the doping control station immediately.

at the time of notification

• DCO/Chaperone may, at his/her discretion, consider any reasonable request by the Athlete for permission to delay reporting to the Doping Control Station following acknowledgement and acceptance of notification and may grant such permission if the Athlete can be continuously chaperoned and kept under direct observation

during the delay.

For In-Competition Testing:

• Participation in a victory ceremony • Fulfilment of media commitments • Competing in further Competitions• Performing a warm down

• Obtaining necessary medical treatment • Locating a representative and/or interpreter • Obtaining photo identification

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Any other exceptional circumstances which may be justified, and which shall be documented

For Out-of-Competition Testing:

• •

Locating a representative

• Completing a training session

• Receiving necessary medical treatment

• Obtaining photo identification

Any other exceptional circumstances which can be justified, and which shall be documented

NOTE: Any reason for not reporting to the doping control station immediately following notification should be indicated on the Doping Control Form and/or a Supplementary Report Form. The DCO may reject this request if it will not be possible for the Athlete to be continuously chaperoned.

• Inform the Athlete that he/she will be accompanied at all times until the end of the sample collection session. The Athlete is responsible for remaining within his/her sight at all times.

• Inform the Athlete that he/she will need to have photo identification with him/her at the doping control station.

NOTE: The DCO should never identify the Athlete himself/herself. Where possible, any identification must be retrievable (i.e. trace the individual back to that form of identification). The following are acceptable forms of identification, listed by priority:

1) Photographic identification, including a driver’s license, passport, sport federation

identification/license card, doping control passport, etc. 2) Third party identification only if a photographic identification for the Athlete is not

available. This could include the Athlete being identified by a coach or parent. This person should sign the Doping Control Form, to acknowledge that he/she identifies the Athlete.

• Inform the Athlete of his/her right to have a representative present during the

processing of his/her sample • Inform the Athlete of possible consequences of refusing or failing to comply

• Inform the Athlete that he/she may not empty his/her bladder prior to his/her arrival at the doping control station and then must do so under the observation of sample collection personnel

with the doping control process

• Inform the Athlete that he/she will have access to more detailed information about the doping control process in the doping control station

• Ask the Athlete to accompany the Chaperone to the doping control station

3. The following information must be included on the notification section of the Doping Control Form

:

• The Type of Test Required – check the urine and/or blood box(es) • The date of the test • The location of the test (country and city) • The time of notification • The Chaperone’s printed name and signature

4. The Athlete should sign the form at the time of notification in the notification section only,

acknowledging his/her selection for doping control and indicating that the information therein is correct.

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5.1 Athlete Notification Procedure © WADA – DCO Manual - Version 3.0 – May 2011

NOTE: At this stage the Chaperone should present the Athlete with the Athlete notification copy of the Doping Control Form. If this is not possible, then the Athlete will be given their copy at the doping control station.

5. Following notification, the Chaperone should keep the Athlete under observation at all times until the end of the sample collection session. The Athlete shall cooperate with the Chaperone to ensure that visual contact with the Athlete is maintained. (See reference 5.1).

NOTE: Chaperones should encourage Athletes to report to the doping control station immediately.

6. Should the Athlete choose to consume fluids prior to arrival at the doping control station it is at his/her own discretion. The Athlete will be responsible for the security and integrity of any drinks or food that the Athlete chooses to consume. The Chaperone should not handle these items for the Athlete.

NOTE: The DCO or Chaperone may offer the Athlete a choice of sealed beverages. The DCO or Chaperone should never handle unsealed food or beverages. It is the Athlete’s choice to either consume his/her own beverage or chose from the selection offered by the DCO or Chaperone.

7. If the Athlete evades, or attempts to evade, the Chaperone in order to avoid being notified and the Chaperone is not able to notify the Athlete he/she must inform the DCO immediately.

8. If an Athlete fails to comply with a request to provide a sample or refuses to accompany the Chaperone to the doping control station, the Chaperone should: • Show the Doping Control Form

• Inform the Athlete of possible consequences of failure to comply

to the Athlete and explain that he/she is required to provide a sample for doping control

• Inform the DCO immediately • Ask the Athlete to write the reason for his/her refusal in the comments box and sign

the Doping Control Form in Section 4. (See Reference 6.9). Should additional room be required, the Athlete may use a Supplementary Report Form.

9. Once the Athlete checks into the doping control station, the Athlete may only leave the

station if he/she has been granted approval by the DCO. Under these circumstances, a Chaperone must accompany and observe the Athlete at all times until he/she returns to the doping control station.

10. If a Chaperone observes any unusual behavior by an Athlete while keeping that Athlete under observation, the Chaperone shall report this to the DCO as soon as practical without leaving the Athlete unattended. The DCO may request that the Chaperone complete a Supplementary Report Form.

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5.1 Athlete Notification Procedure © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist Discretely notify the Athlete that he/she has been selected for doping control. During notification, explain to the Athlete that he/she must remain in the sight of the

Chaperone or DCO at all times until the sample collection process is complete. Complete the notification section of the Doping Control Form, including having the

Athlete read and sign the form. Inform the Athlete that he/she will be required to present identification at the doping

control station and can be accompanied by a representative. The Athlete must report to the doping control station immediately after notification,

unless there are valid reasons for a delay. Establish whether the Athlete has any activities he/she must complete prior to

reporting to the doping control station (e.g. medal ceremony, media commitments, medical treatment, compete in another event, warm down, obtain an interpreter/representative/clothing/identification).

Any reason for not reporting to the doping control station immediately following notification should be indicated on the Doping Control Form and/or a Supplementary Report Form.

The Athlete must remain chaperoned from notification to the completion of the testing procedure, including during any of the above activities.

During media commitments or medal ceremonies, the Chaperone must ensure that he/she is not visible so that it is obvious that the Athlete has been selected for doping control.

Document any occasion where the DCO or Chaperone loses sight of the Athlete or should the Athlete refuse to comply with any of the requirements of the doping control process including remaining with the DCO or Chaperone.

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5.2 Recording Entry/Exit of the Doping Control Station © WADA – DCO Manual - Version 3.0 – May 2011

5.2 Recording Entry/Exit of the Doping Control Station

Purpose The purpose of this section is to outline how entry to and exit from the doping control station is recorded and to identify who is authorized access into the station.

Action It is recommended that an Entry/Exit Log be used for all in-competition and out-of-competition sessions where multiple samples are to be collected at a single testing session. The DCO must control entry to and exit from the doping control station. The Entry/Exit Log should be completed and submitted to the Anti-Doping Organization (ADO) with the doping control documentation. Only the following individuals may be permitted entry into the doping control station. • On duty Doping Control Officer(s) • • Other Sample Collection Personnel on duty

On duty Chaperone(s)

• Athlete(s) being tested • •

Athlete Representative(s)

• Interpreter(s) Relevant Representatives from the relevant National Sport Federation, International Federation and

• ADO Staff event representatives

• Other individuals authorized by the ADO

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5.2 Recording Entry/Exit of the Doping Control Station © WADA – DCO Manual - Version 3.0 – May 2011

ENTRY/EXIT LOG

Anti-Doping Organization EVENT: DATE: Name Of Athlete/ DCO/Chaperone/ Representative

Time In Time Out

Time In Time Out

Time In

Time Out

Signed by DCO

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5.3 Conducting Out-of-Competition Testing © WADA – Version 3.0 – May 2011

5.3 Conducting Out-of-Competition Testing

Purpose The purpose of this procedure is to describe the process for making reasonable attempts to locate an Athlete for out-of-competition testing.

Actions

1. When requesting an out-of-competition test, the ADO should provide the DCO with all relevant information, including: the Athlete whereabouts information; specific instructions regarding the date(s) and time(s) to test the Athlete; and any special instructions/requirements related to the test.

2. The DCO will review all of the information provided by the ADO to determine the best

approach to conducting the test.

3. Prior to beginning the attempt to locate the Athlete, the DCO and/or ADO should ensure they have the most up-to-date whereabouts information for that Athlete.

4. The DCO

a. The should include the following as part of his/her preparation:

DCO

b. Where the location is a public one, e.g., a multi-sports complex, the

should ensure that he/she knows where the location specified is, how he/she is going to get there, and approximately how long it is going to take to get there.

DCO

c. The

should make him/herself familiar in advance with the lay-out of the complex.

DCO should also ensure that he/she knows what the Athlete looks like, so that he/she can identify them when he/she gets to the specified location. ADOs should seek to make photographs of the Athletes available to their DCOs

for this purpose.

5. If the DCO is instructed to make the attempt at the designated 60-minute location and arrives at the location but cannot locate the Athlete immediately, then the DCO should remain at that location for whatever time is left of the 60-minute time-slot and during that remaining time he/she should do what is reasonable in the circumstances to try to locate the Athlete.

NOTE: The DCO should be discreet in attempting to locate the Athlete at the specified location. Where possible, the DCO should not inform others that he/she wants to locate the Athlete for doping control. If the DCO does speak to people during his/her attempt to locate the Athlete, he/she should try to get the names and positions (e.g. neighbour, coach) of the people to include in his/her report. The DCO should not identify the purpose of his/her visit. NOTE: If the specified 60-minute location is the Athlete’s house or other place of residence, the DCO should ring any entry bell and knock on the door as soon as he/she arrives. If the Athlete does not answer, the DCO should not telephone the Athlete to advise him/her of the attempt. Instead, the DCO should wait somewhere close by (e.g.,

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in his/her car) in a place where he/she can observe the (main) entrance to the residence. He/she should then knock/ring again a short time later (e.g., 15 minutes), and should keep doing so periodically until the end of the 60 minutes. At that point, he/she should try one last time at the end of the 60 minutes before leaving the location and completing an Unsuccessful Attempt Report. NOTE: If the Athlete only specifies the sports complex for his/her 60-minute time-slot, and does not specify where in the sports complex he/she will be during the 60-minute time-slot, the DCO should make reasonable attempts to check each of the locations where the Athlete may be within the complex, but if notwithstanding those attempts the Athlete cannot be found then the DCO should file an Unsuccessful Attempt Report.

6.

If the Athlete is not available for testing at the beginning of the 60-minute time-slot, but becomes available for testing later on in the 60-minute time-slot, the DCO should collect the Sample. In addition the DCO should include the full details of the delay in availability of the Athlete in the DCO Report.

7. If the DCO is told that the Athlete is not present at the specified 60-minute location but can be found in an alternative location, then the DCO should record this information (including the name and relationship to the Athlete of the person providing the information), but the DCO should not leave the specified location to go to try and find the Athlete, in case the Athlete is trying to get back to their specified location and the DCO misses him/her while in transit. Instead, the DCO should remain at the specified location for the remainder of the 60-minute time-slot. Thereafter, he/she is entitled to go to the alternative location (if instructed by the ADO) to look for the Athlete. Even if that Athlete is located for testing at the alternative location, however, and a Sample is collected, the DCO should submit an

Unsuccessful Attempt Report.

8. If a DCO fails to locate an Athlete during the 60-minute time-slot, a full detailed report must be submitted to the ADO describing the attempt. The WADA Unsuccessful Attempt Report Form may be used for this.

NOTE: The DCO will record the exact date and time of arrival/attempts, venue address, specific location visited at the venue, the length of time waited, details of persons spoken to, the content of the conversation, and any other relevant details, etc. NOTE: The DCO should note any circumstances he/she observes during his/her attempt to test the Athlete that could be relevant. For example, if the attempt is made at the Athlete’s home, and no one answers the door, the DCO should note whether or not there are any lights on in the house, or if he/she notices any movement in the house. It is up to the DCO

9. If the ADO requests that the DCO attempt to locate the Athlete outside of the 60-minute time-slot, the ADO will provide specific instructions for the DCO to follow during the attempt. This may include requiring the DCO to stay at location for a reasonable amount of time but no less that 30 minutes; proceeding to second specified location for that given day if provided; and continuing this process until all of the relevant specified locations for that Athlete on that day have been visited by the DCO. The attempt(s) made by the DCO outside the designated 60-minute period should also be detailed in writing.

to gather such anti-doping intelligence as may be useful to the ADO. This information should be included in the Unsuccessful Attempt Report.

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5.3 Conducting Out-of-Competition Testing © WADA – Version 3.0 – May 2011

Summary Checklist DCO reviews the information and requirements provided by the ADO for an out-of-

competition test. DCO attempts to locate the Athlete as per instructions from the ADO and in accordance

with the Athlete’s Whereabouts by visiting the location(s) specified.

If the DCO makes an attempt at the location specified for the 60-minute time-slot but cannot locate the Athlete immediately, then the DCO should remain at that location for whatever time is left of the 60-minute time-slot and during that remaining time he/she should do what is reasonable in the circumstances to try to locate the Athlete.

If a DCO fails to locate an Athlete at anytime including during the 60-minute time-slot, a

full detailed report must be submitted to the ADO describing the attempt.

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6.1 Urine Sample Collection Procedure © WADA – DCO Manual - Version 3.0 – May 2011

6.1 Urine Sample Collection Procedure

Purpose The purpose of this procedure is to describe the process for collecting a urine sample from an Athlete.

Actions

The role of the DCO in this procedure is to guide the Athlete. Sample Collection Personnel should not handle the equipment selected by an Athlete prior to the Athlete securing his/her sample, unless specifically requested to by the Athlete.

1. When the Athlete indicates he/she is ready to provide a sample, the DCO

shall ensure that the Athlete is informed of his/her rights and responsibilities and understands the sample collection procedure.

2. The Athlete should select a sealed collection vessel

and verify that it is empty, clean and intact. It is recommended that there be at least three (3) collection vessels from which the Athlete can make his/her selection.

NOTE: If the Athlete is not satisfied that the collection vessel is empty, clean and intact, he/she should: • Select another collection vessel. • If the Athlete is not satisfied that the collection vessel is empty, clean and intact and

there are no other collection vessels available, this should be noted on the Supplementary Report Form• If the DCO agrees with the Athlete that there are no collection vessels suitable

for use, the DCO should contact the Anti-Doping Organization (ADO) immediately to determine the next steps. The sample collection session should not be terminated, as a sample collection kit bottle could be used as a collection vessel.

.

• If the DCO is satisfied that a collection vessel is empty, clean and intact, the DCO shall instruct the Athlete to proceed with the test and will note this on a Supplementary Report Form

.

3. The DCO or Chaperone and Athlete should proceed to the toilet area to collect a sample. 4. The DCO or Chaperone who observes the passing of the Athlete’s sample must be of the

same gender as the Athlete.

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5. If the Athlete is minor and/or has a disability (See reference 6.7, 6.8), the Athlete Representative may, with the consent of the Athlete, accompany him/her into the toilet area to observe the Chaperone or DCO when the Athlete is passing a urine sample, but may not be in view of the Athlete passing the Sample, unless authorized to do so by the Athlete. If the Athlete is a minor and/or has a disability and chooses to have the Athlete Representative accompany him/her, this should be documented on a Supplementary Report Form

. In all cases, the Chaperone or DCO must directly observe the passing of the sample.

6. The Athlete must wash his/her hands prior to providing a sample to ensure their hands are clean and that they can not contaminate the sample with foreign objects.

7. The Athlete should be instructed to remove only the collection cup from the sealed bag

and not to remove the lid until after the sample has been provided. 8. Direct observation

of the urine passing from the Athlete into the collection vessel is critical. The DCO or Chaperone must witness the actual provision of the urine sample by the Athlete to ensure there is no interference with, substitution, or contamination of the sample during the course of the collection. The DCO or Chaperone should explain to the Athlete that in order to ensure the Athlete has provided the sample, the DCO or Chaperone must have a clear and unobstructed view of the passing of the sample. Sample Collection Personnel may want to consider the following suggestions when directly observing the provision of a urine sample:

• Instruct the Athlete to remove clothing that prevents a clear view of the middle of the Athlete’s body, hands and forearms. This should include the Athlete’s shirt being pulled up to mid-torso, sleeves rolled up to the elbows, and trousers pulled down to mid-thigh.

• Male DCOs or Chaperones may find their view is clearer if they position themselves at the side opposite to the preferred hand and to the front.

• Female Athletes may inadvertently obstruct the view with their preferred hand or their hair, so crouching down slightly toward the opposite hand should afford a clearer view.

• An Athlete may react to observation by turning away from the DCO or Chaperone. The DCO or Chaperone must adjust his/her position to ensure an unobstructed view or immediately inform the Athlete to turn back so the unobstructed view is possible.

NOTE: The optimum situation occurs when the DCO or Chaperone and the Athlete are both in the toilet area with the door closed. However, if the toilet area is not large enough, the DCO or Chaperone should ensure that the door remains open with a clear and unobstructed view of the Athlete urinating into the collection vessel. If the door must remain open, the use of the toilet area should be monitored to avoid others from inadvertently interrupting the sample provision process.

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6.1 Urine Sample Collection Procedure © WADA – DCO Manual - Version 3.0 – May 2011

9. The DCO or Chaperone should ensure that 90 mL of urine is collected; however, the DCO or Chaperone should encourage the Athlete to empty his/her bladder and provide as much urine as possible in the collection vessel. If the collection vessel is completely filled and the Athlete's bladder is not yet empty, the Athlete should be instructed to finish emptying his/her bladder into the toilet.

NOTE: If the required volume is not provided, the DCO should follow the Partial Sample

Procedure (See reference 6.4). 10. To protect the urine sample, the Athlete should place the lid on the collection vessel as

soon as possible, particularly when moving from the collection area to the processing area.

11. The Athlete should then be requested to flush the toilet so that no residual urine is left.

12. If the Athlete wishes to wash his/her hands after providing the sample, make sure the

sample is placed in a safe and secure location where both the Athlete and the DCO or Chaperone have a clear and unobstructed view of the sample at all times.

13. Return to the processing area with the Athlete carrying his/her sample. The Athlete should retain control of the collection vessel and any sample provided until the sample collection kit bottles are sealed. The collection vessel must be in clear view of the Athlete, DCO and/or Chaperone at all times. A DCO and/or Chaperone may only handle the collection vessel if requested to do so by the Athlete, and this should be documented on a Supplementary Report Form

.

14. If an Athlete Representative signed into the doping control station with the Athlete, he/she should be present during the remainder of the procedure.

15. The DCO or Chaperone who witnessed the passing of the sample will sign the Urine

Sample Witness line on the Doping Control Form

to verify the Athlete provided the sample and that a clear, unobstructed view was maintained.

NOTE: If during the sample collection session, a sample is deemed by the DCO and/or Athlete to be unsuitable, or if there are doubts as to the origin or authenticity of the sample, the Athlete shall be asked to provide an additional sample. The DCO should refer to the Additional Sample Procedure (See reference 6.5). Unsuitable or non-conforming samples should not be discarded or combined

with urine that has not been compromised. All samples should be sealed in a sample collection kit and sent to the WADA accredited laboratory. The DCO will also report this to the ADO.

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6.1 Urine Sample Collection Procedure © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist A sample must be collected once the Athlete has been notified The Athlete should have a choice of at least three (3) collection vessels The Chaperone or DCO observing sample provision must

The Athlete must wash his/her hands prior to providing a sample

be of the same gender as the Athlete

The Chaperone or DCO must have an unobstructed view of sample provision The Athlete must be encouraged to empty his/her bladder when providing a sample Following sample provision the lid should be placed onto the vessel to cover it The Athlete and DCO/Chaperone must then return to the processing area to complete

the division and sealing of the sample

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6.2 Urine Sample Processing Procedure © WADA – DCO Manual - Version 3.0 – May 2011

6.2 Urine Sample Processing Procedure

Purpose

The purpose of this procedure is to describe the steps for processing a urine sample provided by an Athlete.

Actions

1. Once the Athlete has provided the required 90 mL of urine, the sample processing should begin as soon as practical. The Athlete should retain control of the collection vessel

and any sample provided until the sample is sealed inside the sample collection kit bottles. The collection vessel must be in clear view of the Athlete and DCO or Chaperone at all times.

NOTE: If the volume of urine is insufficient, the Partial Sample Procedure (See reference 6.4) should be followed.

2. The DCO should make note of the total volume of urine in the collection vessel and record

it on the Doping Control Form before the sample is divided into the sample collection kit bottles.

3. If a foreign object is in the Athlete's sample, the DCO should determine whether or not the object compromises the integrity of the sample.

NOTE: If it is determined that the foreign object could compromise the integrity of the sample (i.e. soap), the sample should be processed but an additional sample should be collected following the steps outlined in the Additional Sample Procedure (See reference 6.5). If it is determined that the foreign object does not compromise the integrity of the sample (i.e. blood or hair), the sample should be processed and the DCO should continue with the regular procedures for processing the sample.

4. The DCO should ask the Athlete to select and inspect a sample collection kit (a choice of

at least three (3) kits is recommended) with which he/she is satisfied and in which the sample will be sealed. Each pair of A and B bottles must be secure, in tact and not tampered with prior to the selection by the Athlete.

NOTE: If the Athlete is not satisfied with the sample collection kit selected, he/she should select another kit. If there are no other kits available and the DCO is satisfied with the remaining kit, the DCO shall instruct the Athlete to proceed with the test and should be noted on the Supplementary Report Form. If the DCO agrees with the reasons put forth by the Athlete that the sample collection kit(s) available is/are not satisfactory, the DCO shall terminate the sample collection session and this should be recorded on a Supplementary Report Form

. The DCO should inform the ADO as soon as practical if this situation occurs.

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6.2 Urine Sample Processing Procedure © WADA – DCO Manual - Version 3.0 – May 2011

5. The Athlete should open the sample collection kit selected and remove the A and B bottles from its packaging. The Athlete should check that both bottles have all components in place.

6. The Athlete should check that the bottles and all other parts of the sample collection kit

have the same sample code numbers (one bottle will have a prefix A and the other B). If any of the numbers do not match, then the DCO should ask the Athlete to choose another sample collection kit.

NOTE: The sample code number of any defective kits should be recorded on the

Doping Control Officer Report Form and reported to ADO

. If no additional kits are available, the DCO shall terminate the test and no sample shall be secured. The DCO should inform the ADO as soon as practical if this situation occurs.

7. The DCO should ask the Athlete to read the sample code number so it can be recorded on the Doping Control Form. The DCO should also visually confirm the number before recording it on the Form.

8. Before pouring the sample into the A & B bottles, the DCO will instruct the Athlete to leave

a small amount of residual urine in the collection vessel in order to measure the specific gravity.

9. The Athlete should fill the B bottle

to at least the minimum required volume indicator (30 mL).

NOTE: The B bottle must not be filled beyond the maximum fill line (i.e. if the bottle has a shoulder) as it will be frozen at the laboratory and could break if filled beyond this level.

11. The Athlete should fill the A bottle

as much as possible but at least to the minimum required volume indicator (60 mL).

NOTE: Reasonable efforts should be made to discard a minimal volume of urine. If there is excess urine, the extra urine should be poured into the A and B bottles, with preference given to the A bottle, but not to exceed the shoulder of the bottle. If there is still excess urine after both bottles have been filled, this minimal amount of urine will be disposed of in the presence of the Athlete after the completion of the entire sample processing procedure for that Athlete.

12. The DCO should ask the Athlete to seal the sample collection kit bottles and test the

security of the system to confirm they are sealed. If an Athlete has trouble during the sealing procedure, it is preferable that the Athlete’s Representative (if present) assist the Athlete. The DCO may also help if requested by the Athlete.

NOTE: If the Athlete Representative or DCO assists the Athlete with this procedure, which involves handling the Athlete's unsecured sample, it should be documented on a Supplementary Report Form

.

13. The DCO should also physically verify that the bottles are properly sealed, including turning the sealed bottles upside down to check that they do not leak.

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14. The DCO should record the time of sealing the sample on the Doping Control Form.

15. The DCO should confirm the sample is within the required range by testing the specific

gravity

using the residual volume of urine remaining in the collection vessel. The DCO should record the actual measurement for specific gravity on the Doping Control Form. The DCO should follow the Measuring Specific Gravity procedure (See reference 6.3).

16. The DCO should request that the Athlete provide information about any medications and other substances, including vitamins, minerals, herbs and other dietary supplements, used in the previous seven (7) days (or as requested by the ADO) and any transfusions received in the previous six (6) months. The DCO should record the information on the Doping Control Form

. If the Athlete has no substances to declare, the DCO should write none.

NOTE: If the Athlete has several declarations to be recorded and there is not enough room in the space provided on the Doping Control Form

, continue on a Supplementary Report Form, and record the Supplementary Report Form Number on the Doping Control Form. This Supplementary Report Form must not include the Athlete’s name or initials and will not be signed by the Athlete.

NOTE: DCOs must not

offer advice on substances/medications, question the purpose of any medication or enter into any discussion on the status of a medication.

17. The DCO should ask the Athlete to read and complete the Consent for Research area of

the Doping Control Form. This includes the Athlete signing this area of the form. 18. The DCO should complete the Doping Control Form

. The DCO who processes the Athlete’s sample(s) is responsible for ensuring that the form is complete, accurate and legible. If any of the information on the Doping Control Form is not applicable, the DCO should draw a line through each non-applicable area, and check the N/A box, if available.

NOTE: The Doping Control Form should be filled out as completely as possible before reviewing it with the Athlete. The only information that should be left blank during the review is the signature lines of the applicable persons present (e.g. DCO, Athlete Representative and Athlete).

NOTE: The DCO should confirm that the appropriate Athlete identification information was provided. Acceptable forms of identification include a driver’s license, passport, sport federation identification/license card, doping control passport, etc.

19. Once the Doping Control Form is completed, the DCO should thoroughly review it with the

Athlete and Athlete Representative, if present. If there are any mistakes on the Form, a new one should be re-written and the Form with the error should be voided and torn up while in the Athlete’s presence. This voided Form should be returned to the ADO along with the other sample collection documentation.

20. If the DCO, Athlete, Chaperone or Athlete Representative express an interest in making

written comments specific to the Athlete’s sample or the testing session, they may do so

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on the Doping Control Form or, if additional space is required, on a Supplementary Report Form

. The Supplementary Report Form number will be recorded on the Doping Control Form.

21. The DCO, Athlete Representative (if applicable), and Athlete will then print and sign their names on the Doping Control Form

to verify the accuracy of the information.

NOTE: The DCO and any other applicable person besides the Athlete should sign first. The Athlete should be the last person to sign the Doping Control Form

. When the DCO signs the Form, he/she will also record the time of completion on the Doping Control Form.

22. The DCO should provide the appropriate copy(s) of the Doping Control Form and, if applicable, the Supplementary Report Form

to the Athlete at the conclusion of the Sample Collection Session.

NOTE: If a Supplementary Report Form was filled out, the DCO should record the Form number on the Doping Control Form

to link all necessary sample collection documentation to the Athlete's test.

NOTE: If an error on any of the Athlete's sample collection documentation is noticed after the Athlete was released from the doping control station, the document should not be altered. In this case, the DCO should complete a Supplementary Report Form explaining the error and the Form number should be recorded on the Doping Control Officer Report Form.

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6.2 Urine Sample Processing Procedure © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist The Athlete’s sample meets minimum volume requirements of 90 mL of urine The Athlete has a minimum of three (3) sample collection kits to choose from The Athlete verifies that the A and B bottles and all other parts of the sample collection

kit have the same sample code number The minimum amount of 30 mL of urine is poured into the B bottle The minimum amount of 60 mL of urine is poured into the A bottle The A and B bottles are securely sealed The details of the bottle number, volume and specific gravity are recorded on the Doping

Control Form All applicable areas of the Doping Control Form are completed and a line is drawn

through any non-applicable areas The Athlete is the last person to sign the Doping Control Form

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6.3 Measuring Specific Gravity © WADA – DCO Manual - Version 3.0 – May 2011

6.3 Measuring Specific Gravity

Purpose

The purpose of this procedure is to describe the process for measuring the specific gravity of a urine sample.

Actions

NOTE: When pouring urine into the A and B bottles the DCO will instruct the Athlete to leave a residual amount (<2ml) in the collection vessel. The DCO should not perform specific gravity testing on a partial sample

. In this case, the measurements should only be done after the combined amount of urine meets the minimum volume requirements and has been sealed in the A and B bottles.

1. The DCO must only test residual urine after the A and B bottles have been filled and sealed. The DCO should not immerse any object into the sample prior to sealing the sample in the sample collection kit

bottles.

2. The DCO should ensure that the reagent strips

have not expired.

3. The DCO should ensure that his/her hands are clean and dry before handling the collection vessel and reagent strip.

4. The DCO should remove one reagent strip from the container, and reseal the container

without too much delay.

NOTE: A refractometer can also be used to measure specific gravity. Should the ADO provide you with a refractometer, please follow the ADO’s instructions on how to use it to measure specific gravity.

5. The DCO will dip the reagent strip into the residual urine ensuring the applicable pads

for specific gravity are wet.

6. The DCO should remove any excess urine from the strip, by gently sliding the strip along the lip of the collection container while maintaining the strip in a horizontal position. There also should not be any liquid bridging the gaps between the reagent pads on the strips.

NOTE: Do not dab or wipe the reagent pads with paper towel directly. Remember that excess urine could cause the reading to be falsely low and wiping or dabbing the face of the strip can cause the colors on the pads to mix.

7. The DCO should hold/place the strip in a horizontal position so that adjacent reagent

pads cannot mix.

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8. The DCO will wait 45 seconds before recording the specific gravity.

9. Holding the container and strip horizontally, the DCO should compare the color(s)

developed on the strip to the corresponding color on the color chart found on the container.

10. When using a reagent strip, t

he specific gravity must be greater than or equal to 1.010.

NOTE: When using a refractometer, the specific gravity must be greater than or equal to 1.005.

11. If the specific gravity measurement is outside of the required range, the Athlete should

be informed that his/her initial sample does not meet the specifications and an additional sample will be collected. All samples collected from an Athlete will be processed and shipped to the laboratory for analysis and reporting. Please refer to the Additional Sample Procedure (

See reference 6.5).

NOTE: If the specific gravity of the first sample does not meet the minimum requirement the DCO may discourage the Athlete from hydrating.

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6.4 Partial Sample Procedure © WADA – DCO Manual - Version 3.0 – May 2011

6.4 Partial Sample Procedure

Purpose The purpose of this procedure is to describe the process for handling and documenting any partial sample that may be provided by an Athlete.

Actions

1. If the required volume of urine (i.e. 90 mL) is not provided, the DCO shall inform the Athlete that additional urine shall be collected to meet the minimum volume requirements.

NOTE: The Athlete should retain control of the collection vessel. The collection vessel

must be in clear view of the DCO or Chaperone

at all times.

2. The DCO should record the volume of urine of the partial sample in the Partial Sample section of the Doping Control Form.

3. The DCO will ask the Athlete to choose a partial sample kit (a choice of at least three (3)

is recommended). The Athlete will be asked to ensure that the packaging for the partial sample kit is properly sealed, clean and intact and that he/she is satisfied with the kit.

4. The DCO will ask the Athlete to open the partial sample kit. NOTE: The Athlete Representative, if present, or the DCO may assist the Athlete if

requested to do so by the Athlete. If this is the case, it should be documented on a Supplementary Report Form

.

5. The DCO should ask the Athlete to read the partial sample kit number so it can be recorded on the Doping Control Form. The DCO should also visually confirm the number before recording it.

6. The DCO should ask the Athlete to seal the partial sample kit. If an Athlete has trouble

during the sealing procedure and requests assistance, it is preferable that the Athlete’s Representative (if present) assist the Athlete. The DCO may also help if requested by the Athlete.

7. The DCO will record the time that the partial sample was sealed in the Partial Sample

section of the Doping Control Form and show the Athlete the number recorded. 8. The DCO and Athlete will initial the Doping Control Form, in the Partial Sample section,

acknowledging that the recorded details are correct. 9. The sealed partial sample will be retained by the DCO in the doping control station.

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10. While waiting to provide additional urine, the Athlete shall remain under continuous observation of the Chaperone or DCO and should be given an opportunity to hydrate.

NOTE: The DCO or Chaperone may offer the Athlete a choice of sealed beverages. The DCO or Chaperone should never handle unsealed food or beverages. It is the Athlete’s choice to either consume his/her own beverage or chose from the selection offered by the DCO or Chaperone.

11. When the Athlete is ready to provide additional urine

, the Athlete should be instructed to select a new collection vessel and the Urine Sample Collection Procedure should be followed (See reference 6.1).

12. When additional urine has been provided the DCO and the Athlete will check that the partial sample kit is sealed and intact, and confirm its identity by checking partial sample kit number.

NOTE: If, during the inspection of the partial sample kit, tampering is evident, or if the

partial sample number does not correspond with what is written on the Doping Control Form

, the DCO should refer to the Additional Sample Procedure (See reference 6.5).

13. The Athlete should open the sealed partial sample kit. 14. The Athlete will be instructed to select a new collection vessel (a choice of at least three

(3) is recommended) and begin combining the samples, starting with the first partial sample provided and each subsequent sample until at least

90 mL is obtained.

NOTE: If an Athlete provides more than 90 mL of urine, the DCO will ensure that all of the urine is combined.

15. If the combined urine volume is still less than 90 mL, the Athlete shall select a new partial sample kit and repeat the partial sample procedure until the combined volume meets the minimum required volume of urine.

NOTE: If an Athlete provides more than two (2) partial samples, then the DCO should

use a new Doping Control Form in order to record the additional partial sample kit numbers. Should an additional Doping Control Form be used for the same Athlete, the DCO shall transcribe all Athlete information from the first Doping Control Form to the additional form.

16. Once the combined urine volume is at least 90 mL, the sample can be processed. The

last person who witnessed the sample provision must sign and print his/her name on the Doping Control Form

, in the Confirmation of Procedure for Urine on the Urine Sample Witness line. Proceed to the Urine Sample Processing Procedure (See reference 6.2).

NOTE: The DCO should aim to ensure that the same Chaperone or DCO observes the different partial samples and additional samples (where appropriate) for the same Athlete to ensure consistency and total chain of custody with the Athlete. If the same person who witnessed the initial partial sample provision did not witness the additional urine provision(s), the last witness should sign the Doping Control Form, in the Urine Sample Witness box but the previous witness should complete a Supplementary Report

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6.4 Partial Sample Procedure © WADA – DCO Manual - Version 3.0 – May 2011

Form to record the witnessing of the previous sample provision. The DCO should also provide details as to why the same person did not witness each provision.

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6.4 Partial Sample Procedure © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist If an Athlete provides less than 90 mL of urine then the partial sample process should be

initiated The Athlete selects a partial sample kit and uses it to seal the partial sample The partial sample kit number, volume and time sealed is recorded on the Doping

Control Form in the Partial Sample section The Athlete and DCO initials the partial sample section of the Doping Control Form The DCO maintains custody of the partial sample The DCO instructs the Athlete to select a new collection vessel and to begin combining

the samples, starting with the first partial sample provided and each subsequent sample until at least

If the combined sample is still below the minimum required volume of urine (i.e. 90 mL) then the procedure should be repeated until the minimum is achieved

90 mL is obtained

Once the required volume (i.e. 90 mL) of urine is provided, the DCO proceeds to the Urine Sample Processing Procedure

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6.5 Additional Sample Procedure © WADA – DCO Manual - Version 3.0 – May 2011

6.5 Additional Sample Procedure

Purpose

The purpose of this procedure is to outline when an Athlete may be required to provide an additional sample and describe the process for handling and documenting an Athlete's subsequent sample.

Actions

1. The Athlete should be informed that an additional sample must be collected, processed and shipped to the laboratory, if one or more of the following conditions apply, or if otherwise deemed necessary by the DCO

:

• The sample's specific gravity

• The Athlete did not maintain custody of his/her unsecured sample or the sample was not in clear view of the DCO or

does not meet the required minimum (See reference 6.3);

Chaperone

• The sample has a foreign object in it that could compromise the integrity of the sample (e.g., soap, etc.);

;

• The Athlete refused or failed to comply

• The Chaperone or DCO did not have an unobstructed view of the passing of the initial Sample (in this case, the Chaperone or DCO should not sign the Urine Sample Witness line of the

with instructions made by the DCO or Chaperone during the collection of the Athlete's initial sample (e.g. the Athlete does not disrobe, the Athlete does not allow for direct observation of the passing of the sample);

Doping Control Form

• The DCO or Chaperone observed unusual behavior by the Athlete while witnessing the passing of the Athlete's initial sample;

, and should follow the steps outlined in this procedure);

• The DCO or Chaperone have doubts as to the origin or authenticity of the Athlete's sample;

• Upon examination of the sealed partial sample kit containing the Athlete's partial sample

• The sample is sealed improperly in a defective

, the DCO and/or Athlete find signs of tampering; or

sample collection Kit

.

2. Unsuitable or non-conforming samples should not be discarded or combined with urine that has not been compromised. All samples should be sent to the WADA accredited laboratory and reported to the ADO.

If the unsuitable, or non-conforming sample meets the volume requirement for initial samples (i.e. 90 mL), the sample should be processed according to standard procedures

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(see reference 6.2)

, but an additional sample shall be collected according to this procedure.

If the unsuitable, or non-conforming sample does not

meet the volume requirement for initial samples (i.e. less than 90 mL), the sample should be processed according to standard procedures, with the exception of splitting the volume of urine evenly between the A and B bottles. If there is not enough urine to split the sample evenly, then pour all of the partial sample into the A bottle and secure it. An additional sample shall be collected according to this procedure. Whenever it is necessary to seal a partial sample in the A bottle only, it may not be possible to measure the specific gravity of the sample. In this case, a Supplementary Report Form should be completed.

NOTE: The last person who witnessed the Athlete provide the sample should sign and print his/her name on the Urine Sample Witness line of the Doping Control Form

.

3. Once the initial sample is processed and sealed inside the sample collection kit

bottles, it should remain in the DCO's custody at all times.

4. A Supplementary Report Form

should be completed to document the reason(s) that the sample was determined to be potentially unsuitable or non-conforming except in the case where the sample did not meet the specific gravity requirements.

5. While waiting to provide an additional sample, the Athlete shall remain under continuous observation of the Chaperone or DCO and should be given an opportunity to hydrate. NOTE: If the specific gravity of the first sample does not meet the minimum requirement the DCO may discourage the Athlete from hydrating.

6. When the Athlete is ready to provide an additional sample, he/she shall select a collection

vessel from a number of sealed collection vessels available (a choice of at least three (3) is recommended), visually check that it is empty, clean and intact, proceed to the toilet area and urinate a minimum of 90 mL into the collection vessel. All steps of the Urine Sample Collection Procedure

(See reference 6.1) should be followed.

7. If the Athlete is unable to provide the minimum required volume of urine (i.e. 90 mL), the Partial Sample Procedure (See

reference 6.4) should be followed and the Partial Sample section of the Doping Control Form should be completed.

8. If the Athlete provides the minimum required volume (i.e. 90 mL) of urine, the Urine Sample Processing Procedure (See reference 6.2).

9. All samples will be recorded on the Doping Control Form(s). Whichever sample was

collected first should be recorded in the first space provided for the sample code number

and other required information; the additional sample(s) should be recorded in the Sample 2 section of the Doping Control Form.

NOTE: Should an additional Doping Control Form be used for the same Athlete, the DCO shall transcribe all Athlete information from the first Doping Control Form to the additional form. The sample code numbers from the first form should be recorded in the Comments section of the additional Doping Control Form.

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6.5 Additional Sample Procedure © WADA – DCO Manual - Version 3.0 – May 2011

10. If the same person who witnessed the collection of the initial sample witnessed the

collection of the subsequent sample(s), then that person should sign all Urine Sample Witness boxes at the bottom of the Doping Control Form (use additional Doping Control Forms if necessary). If there were different witnesses, each witness should sign the Urine Sample Witness boxes at the bottom of the Doping Control Form to verify that the Athlete provided the samples and that a clear, unobstructed view was maintained. A Supplementary Report Form should be completed to document the reason why there were different witnesses.

11. The DCO should confirm that the sample is within the specified ranges by testing the

specific gravity of the residual volume of urine remaining in the collection vessel. The DCO should follow the Measuring Specific Gravity Procedure (

See reference 6.3).

12. The specific gravity measurement should be recorded in the appropriate area of the Doping Control Form

.

13. The DCO should continue to collect additional samples until a suitable sample is provided or until the DCO determines that there are exceptional circumstances (i.e. logistical reasons) which make it impossible to continue with the sample collection session.

14. The DCO will document the reasons for concluding the sample collection session without

obtaining a suitable sample in the Doping Control Report Form or a Supplementary Report Form and inform the ADO as soon as possible.

15. All samples should be sent to the laboratory for analysis and reporting according to the

Procedures for Sending Samples to the Laboratory (See reference 8.1).

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6.5 Additional Sample Procedure © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist The DCO determines that an additional sample is required, based on –

The sample’s specific gravity is outside the normal range; The Athlete did not maintain custody of his/her unsecured sample; The Athlete’s unsecured sample was not in clear view of the DCO or Chaperone; The sample contains a foreign object that could compromise the integrity of the

sample; The DCO or Chaperone observed unusual behavior by the Athlete while witnessing

the passing of the sample; The DCO or Chaperone has doubts as to the origin or authenticity of the Athlete’s

sample; The DCO or Chaperone did not have an unobstructed view of the passing of the

Athlete’s sample; or The DCO or Athlete suspects that the partial sample kit has been tampered with.

The DCO must process all unsuitable or non-conforming samples and should not discard or combine with urine that has not been compromised.

The DCO will document the reason(s) a sample was determined to be potentially unsuitable or non-conforming on a Supplementary Report Form.

The Athlete will remain under continuous observation of the DCO or Chaperone while waiting to provide an additional sample.

All samples are processed according to the Urine Sample Processing procedure.

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6.6 Completion of the Sample Collection Session © WADA – Version 3.0 – May 2011

6.6 Completion of the Sample Collection Session

Purpose

The purpose of this procedure is to describe the process the DCO will go through when concluding a sample collection session.

Actions

1. Once the Athlete has left the doping control station no amendments can be made to the Doping Control Form. It is important that the DCO checks each Doping Control Form prior to the Athlete leaving the doping control station. NOTE: If an error on any of the Athlete's sample collection documentation is noticed after the Athlete was released from the doping control station, the document should not be altered. In this case, t

he DCO should complete a Supplementary Report Form explaining the error and the Form number should be recorded on the Doping Control Officer Report Form.

2. The DCO, or other appropriate sample collection personnel, should ensure that the Entry/Exit Log is completed and up to date every time an Athlete enters or leaves the doping control station.

3. For every sample collected (including additional samples) the bottle numbers must be

entered onto the Chain of Custody Form (See reference 7.3, 7.4).

4. It is recommended that the DCO places completed samples into the courier transport bag as soon as possible together with the laboratory section of the Doping Control Form and ensures the courier bag remains under the control and observation of the DCO.

5. The courier transport bag can be sealed once all samples have been placed in the bag,

along with all laboratory copies of the Doping Control Form and the Chain of Custody Form.

6. The DCO must ensure that the chain of custody is completed fully from the time the bag

was sealed until the courier transport bag is handed over to the courier or laboratory. All changes in custody of the samples must be clearly recorded so that chain of custody is not broken (See reference 7.3, 7.4).

7. The DCO should record the seal number used to secure the courier transport bag on the

Chain of Custody Form (if a seal is used).

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6.6 Completion of the Sample Collection Session © WADA – Version 3.0 – May 2011

8. Each time the courier transport bag is sealed/opened, the DCO should record the time sealed/opened and the new seal number used to re-secure the bag on the Chain of Custody Form. The DCO should record the reason for opening the courier transport bag on the Doping Control Officer Report Form.

9. When the DCO leaves the doping control station they must ensure that the room used is

tidy and any garbage is disposed of accordingly. All equipment, documentation, signs, posters and leaflets must be taken away by the DCO.

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6.6 Completion of the Sample Collection Session © WADA – Version 3.0 – May 2011

Summary Checklist All boxes on the Doping Control Form are completed or struck through All signatures are legible All the times entered on the Doping Control Form are in chronological order The Entry/Exit log is completed The Chain of Custody Form is completed with all sample codes cross checked All lab copies of the Doping Control Form and Chain of Custody Form are inside the

courier transport bag with the samples The time of bag sealing and the seal number are recorded on the Chain of Custody Form

and all transfers and handovers also documented All equipment and documentation is taken away and not left in the doping control station

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6.7 Modifications for Testing Athletes with a Disability © WADA – DCO Manual - Version 3.0 – May 2011

6.7 Modifications for Testing Athletes with a Disability

Purpose

The purpose of this procedure is to describe the guidelines a DCO should follow when collecting a sample from an Athlete with a disability.

Actions

1. In planning and assigning DCOs

for in-competition and out-of-competition testing, the ADO will attempt to determine whether the assigned testing involves Athletes with disabilities. In the event that the ADO is unable to do so, the DCO will be responsible for making this determination.

2. The DCO shall have the authority to make modifications as the situation requires as long as such modifications will not compromise the integrity, security or identity of the sample and are authorized by the Athlete and/or his/her representative.

3. Modifications to the procedures may be necessary when notifying an Athlete with a disability, however where possible the DCO should adhere to the Athlete Notification Procedure (See reference 5.1). NOTE: Consideration for notifying a third party may be made when testing an Athlete with a disability.

4. Modifications to the Urine Sample Collection Procedure (See reference 6.1) will be required for Athletes who:

• Have restricted mobility or coordination that prevents application of the standard

sample collection procedure; • Have visual impairment; • Have neurological or developmental disabilities; or • Have a catheter or condom device to allow urine production.

NOTE: The Athlete may authorize his/her Athlete Representative to accompany him/her into the toilet area to observe the Chaperone or DCO when the Athlete is providing his/her sample. The Athlete Representative may not view the passing of the Athlete's sample, unless authorized to do so by the Athlete. In all cases, however, the Chaperone or DCO must directly observe the passing of the sample.

5. Other than the modifications outlined in this procedure, the provisions of the standard Urine Sample Collection Procedure (See reference 6.1), and the Urine Sample Processing Procedure (See reference 6.2) should apply.

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6.7 Modifications for Testing Athletes with a Disability © WADA – DCO Manual - Version 3.0 – May 2011

6. Any special accommodations made for an Athlete with a disability should be noted on a Supplementary Report Form

.

7. The DCO should explain the collection and processing procedures and any modifications to the Athlete and/or his/her Representative

.

8. If the Athlete is unable to handle the collection vessel, carry the sample, split the sample into the A and B bottles or seal the A and B bottles, either the Athlete Representative (preferably) or the DCO may perform these tasks if requested by the Athlete. This should be documented on a Supplementary Report Form

.

NOTE: DCOs should only handle equipment as a last resort and when requested by the Athlete.

9. When testing an Athlete with a disability, write the complete name of the sport on the

Doping Control Form. For example, Paralympic Cycling, Wheelchair Rugby, etc., should be recorded on the Sport Discipline line in the Athlete Information Section. The correct sport may be indicated on the assignment request received from ADO and/or on the Athlete's whereabouts information

.

Athletes with visual impairments 10. An Athlete with a visual impairment should be accompanied at all times during the

sample collection session by an Athlete Representative, preferably of the Athlete’s choice.

11. The Athlete Representative may sign the Doping Control Form or Supplementary Report Form

on behalf of the Athlete.

12. The Athlete should, wherever practical, be provided with the opportunity to inspect any and all sample collection equipment by touch. For those portions of the protocol where visual inspection is required (e.g., sample code number), the Athlete Representative should be afforded the opportunity to inspect the sample collection kit

.

13. For out-of-competition testing at an Athlete’s residence, it is recommended that the DCO and Chaperone only enter the premises if the Athlete’s Representative is present.

Athletes with neurological or developmental disabilities 14 An Athlete with a neurological or developmental disability should be accompanied at all

times during the sample collection session by an Athlete Representative, preferably of the Athlete’s choice.

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6.7 Modifications for Testing Athletes with a Disability © WADA – DCO Manual - Version 3.0 – May 2011

Athletes with drainage systems 15. Athletes who are using urine collection or drainage systems should, when practical,

choose one of the following means for provision of their Samples: • If indwelling catheter or condom drainage is used, the Athlete should ideally discard

the collection bag in use and attach a new, unused bag to the catheter. The urine collected in this new bag will be drained into the collection vessel as the sample to be processed.

• If replacing/disconnecting the bag already in use is difficult due to the type of catheter

used, the existing bag must be fully emptied, and a fresh sample collected in the bag. The fresh urine collected in the bag will be drained into the collection vessel as the sample to be processed.

• The sample may also be taken directly through the catheter into the collection vessel.

The Athlete or attendant, under the Athlete's instruction, may temporarily clamp off the catheter to the leg bag.

16. As is the case with all sample collection procedures, the catheterization process will be

witnessed. The collection bag should be drained and replaced (if possible) as soon as practical following notification. Using the contents of the sample collection bag prior to notification is not an acceptable sample.

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6.8 Modifications for Testing Athletes are Minors © WADA – DCO Manual - Version 3.0 – May 2011

6.8 Modifications for Testing Athletes who are Minors

Purpose

The purpose of this procedure is to describe the guidelines a DCO should follow when collecting a sample from a Minor (young athlete).

Actions

NOTE: The age under which an Athlete is considered a Minor will be sport specific and form part of the rules and regulations of the ADO. The age under which an Athlete is considered a Minor in a country may also be defined by law. If testing occurs at an international event the ADO and/or DCO should consult with the International Federation to determine if their rules define the age of a Minor at their competitions. If the IF rules do not define a Minor, then the rules and/or laws of the country will be followed. 1. When conducting testing the DCO will attempt to determine whether the sample

collection session will include Minors. 2. The DCO will offer the Minor with the opportunity to have an adult Representative of

his/her choice present throughout the testing process, including:

• At notification; • During sample collection (i.e. witnessing the sample collection); and • During sample processing (i.e. during the division and sealing of the sample)

3. Once verbally notified the DCO and/or Chaperone should then accompany the Athlete to his/her Representative and complete official written notification.

4. At this stage the DCO should ascertain whether the Minor wants the Athlete

Representative to be present throughout the testing process. Note: If the Minor requests that the Athlete Representative be present during the sample provision stage the diagram below should be used as an example to ensure that all necessary individuals are present. The role of the Athlete Representative will be either, • To only supervise the DCO/Chaperone who is witnessing the sample provision

(without directly observing the sample provision); or • To be in the sample provision area and directly witnessing the sample being provided

along with the DCO/Chaperone if requested by the Athlete. 5. If the Minor does not wish to have his/her Representative present during the sample

provision, the DCO will appoint a Secondary Observer to act in this role. This Secondary

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6.8 Modifications for Testing Athletes are Minors © WADA – DCO Manual - Version 3.0 – May 2011

Observer can be another DCO or Chaperone and his/her role is to ensure that the sample observing DCO or Chaperone is completing his/her duties appropriately.

6. The presence of the Athlete Representative and/or Secondary Observer will be

documented by the DCO in the Doping Control Report Form. 7. The Athlete Representative will print and sign the Athlete Representative section of the

Doping Control Form.

A

B

C

Sample Collection Arrangement

A

B

C

Minor Athlete

Witnessing DCO/Chaperone (to be in a position to directly observe the sample provision)

Secondary Observer and/ or Athlete Representative (if not requested to directly witness the sample provision)

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6.9 Reporting a Potential Failure to Comply © WADA – DCO Manual - Version 3.0 – May 2011

6.9 Reporting a Potential Failure to Comply

Purpose

The purpose of this procedure is to describe the steps that the DCO should take when an Athlete fails to comply with the testing protocol or demonstrates unusual behavior.

Actions

1. The DCO

shall consider any incidents he/she observes of unusual behavior by an Athlete selected to provide a sample, or that is reported to him/her by a Chaperone as soon as practical, ideally before the end of the Athlete’s sample collection session.

NOTE: Examples of unusual behavior may include the Athlete acting suspiciously in providing his/her sample or in his/her general demeanor; any suspicious, collusive activities with other Athletes or personnel; a failure to comply

with the requirements outlined for the Athlete upon notification, the Athlete evading the Chaperone to avoid being notified; or any other situations where the DCO or Chaperone cannot confirm the security or authenticity of the sample.

2. After considering the information available about the incident or the unusual behavior, the DCO shall determine how to proceed and, if necessary, explain the possible consequences to the Athlete. NOTE: If after considering the information available about the potential failure to comply or the unusual behavior, the DCO believes the integrity of the Athlete’s sample has not been compromised, the DCO shall make reference to the potential failure to comply or the unusual behavior in a Supplementary Report Form and in the Doping Control Officer Report Form

and continue with the Athlete’s sample collection session according to the sample collection procedures (see reference 6.1). If the DCO believes the potential failure to comply may have compromised the integrity of the Athlete's sample, the DCO shall, if possible, notify the Athlete of the possible consequences of the potential failure to comply and that they will be required to provide an additional sample and that both samples will be shipped to the laboratory. Refer to the Additional Sample Procedure (see reference 6.5).

3. If the Athlete is required to provide an additional sample and refuses to do so, the DCO should follow the steps 5-12 outlined below.

4. If the DCO believes that any Athlete Support Personnel are hindering the sample collection process this should be recorded on the Supplementary Report Form and on the Doping Control Officer Report Form.

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6.9 Reporting a Potential Failure to Comply © WADA – DCO Manual - Version 3.0 – May 2011

5. The ADO should be informed as soon as practical of any potential failure to comply.

NOTE: If the DCO and/or Chaperone believe that the situation poses a personal threat or potential danger, the DCO and/or Chaperone may decide to terminate the attempt to test. If this happens, the DCO should notify ADO

as soon as practical.

Refusal

6. The DCO shall, if possible, notify the Athlete that the information regarding the Athlete’s

refusal will be documented on a Supplementary Report Form and will be submitted to ADO, and the reason for refusal may also be documented in the “Comments” area of the Doping Control Form. The

Athlete will also be informed that he/she may be subject to sanctions consistent with an anti-doping rule violation for refusing to provide a sample.

NOTE: The DCO may contact the ADO for assistance at any point during the attempt. 7. The DCO should thoroughly fill out the Supplementary Report Form

(see reference 7.7, 7.8).

8. If possible, the DCO should thoroughly review the Supplementary Report Form and the Doping Control Form, if used,

with the Athlete, and attempt to obtain the Athlete's signature.

9. The Athlete may also fill out a Supplementary Report Form

.

10. Whenever possible, the DCO should provide the appropriate copy of the Supplementary Report Form(s) and Doping Control Form, if applicable,

to the Athlete before he/she leaves the DCO's presence.

11. The DCO will inform the ADO as soon as practical of any potential failure to comply. The DCO shall forward the information documenting the Athlete’s refusal to the ADO Office with any other sample collection documentation.

12. If after a DCO completes a Supplementary Report Form documenting the refusal and if

the Athlete has not left the sight of the DCO, the Athlete referred to in the Supplementary Report Form

contacts the DCO and requests to immediately provide a sample, the DCO shall contact the ADO immediately for advice.

Athlete Claim of Retirement

13. In an out-of-competition test, even if the Athlete claims that he/she has retired, the

sample collection session should be completed. 14. The DCO may not cancel the sample collection session based on an Athlete’s statement

regarding retirement.

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6.9 Reporting a Potential Failure to Comply © WADA – DCO Manual - Version 3.0 – May 2011

15. If requested, the Athlete may complete a Supplementary Report Form

documenting his/her concern.

16. If the Athlete refuses to comply with the request for a test, the DCO should follow the steps outlined above for a refusal to test. The DCO should explain to the Athlete that the consequences of a refusal, including potential sanctions, may still apply even if the Athlete claims to be retired or retires after his/her refusal.

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6.9 Reporting a Potential Failure to Comply © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist The DCO will consider any unusual behavior by an Athlete selected to provide a sample,

such as, The Athlete acting suspiciously in providing his/her sample The Athlete acting suspiciously in his/her general demeanor Any suspicious, collusive activities with other athletes or personnel A failure to comply with the requirements outlined for the Athlete upon notification The Athlete evading the Chaperone to avoid being notified Refusal to provide an additional sample if required Any other situations where the DCO or Chaperone cannot confirm the security of

the sample The DCO will determine whether to take further action and explain the possible

consequences to the Athlete, including potential sanctions The DCO will record on a Supplementary Report Form and on the Doping Control Report

Form any incidents where he/she believes that any Athlete Support Personnel are hindering the sample collection process

The DCO will inform the ADO as soon as practical of any potential failure to comply If the Athlete refuses to provide a sample, the DCO will –

Notify the Athlete that the information regarding the Athlete’s refusal will be submitted to the ADO

Inform the Athlete he/she may be subject to sanctions consistent with an anti-doping rule violation for refusing to provide a sample

Thoroughly fill out the Supplementary Report Form regarding the Athlete’s refusal and review it with the Athlete if possible

Inform the Athlete that he/she may complete his/her own Supplementary Report Form

Review and attempt to obtain the Athlete’s signature on the Doping Control Form, if used, and/or Supplementary Report Form

Whenever possible, provide the appropriate copy of the Supplementary Report Form(s) and Doping Control Form (if applicable) to the Athlete

Forward the information documenting the Athlete’s refusal to the ADO with any other sample collection documentation

If the Athlete claims that he/she has retired, the DCO will – Continue with the sample collection session Allow the Athlete to complete a Supplementary Report Form documenting the

Athlete’s concerns, if requested Follow the steps outlined for a refusal should the Athlete continue to refuse to

provide a sample

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7.1 Completing the Doping Control Form © WADA – DCO Manual - Version 3.0 – May 2011

7.1 Completing the Doping Control Form

Purpose The purpose of this instruction is to ensure the Doping Control Form, developed by WADA, is completed appropriately. These instructions are to be used in conjunction with Version 5 (2-2010) of the Doping Control Form.

General Comments/Instructions to the Athlete The 24 hour clock should be used for all times e.g. eight thirty in the morning (8:30 am)

is 08:30, and eight thirty in the evening (8:30 pm) is 20:30. The date format is DD/MM/YYYY therefore the 7th

Write clearly in block capitals and press hard to ensure all copies are legible.

September 2009 is written 07/09/2009.

If you have insufficient space on any part of the form, you may use an additional Doping Control Form or a Supplementary Report Form. This additional Form should be linked to the Doping Control Form (e.g. sample code number, Supplementary Report Form number, etc.).

Any deviation from the standard procedure must be noted on a Supplementary Report Form or a Doping Control Officer Report Form.

The DCO will draw a clear line through any part of the form which is not applicable, including unused boxes for sample code numbers.

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7.1 Completing the Doping Control Form © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist Top Right Section of the Form Test Authorized By: The DCO will insert the name of the organization which

initiated/authorized the test. Sample Collection Agency: The DCO will insert the name of the organization which has

certified him/her to conduct sample collection. Results Management Authority: The DCO will insert the name of the organization under

whose anti-doping rules possible violations would be managed (e.g. the International Federation, National Anti-Doping Organization).

Section 1. Athlete Information The Athlete should be asked to provide information related to all boxes. The Athlete shall assist the DCO with spelling if necessary. Sport Discipline The

is the sport and the discipline of the Athlete. E.g. skiing/freestyle. address

It is the Athlete’s responsibility to provide a piece of photo identification. If this is not available, the DCO will check the

is the address where the Athlete spends most time.

no box

If the Athlete does not have the name of their

, and document in the DCO Report how the Athlete was identified.

coach and/or doctor

, a line should be drawn through these fields.

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7.1 Completing the Doping Control Form © WADA – DCO Manual - Version 3.0 – May 2011

Section 2. Notification The DCO shall complete the information on type of test (for tests for both blood and

urine check both boxes), date, location, and time of notification The Athlete will be provided an explanation of the notification and asked to sign the

receipt of notification.

.

If the Athlete refuses to provide a sample, the Athlete shall be asked to write the reasons in the comments box

The DCO/Chaperone will provide the Athlete the , and sign the Doping Control Form in Section 4.

notification section

The DCO shall ensure the Athlete is aware of their

of the form (top of orange copy – tear along perforation between sections 2 and 3).

rights and responsibilities

as detailed on the reverse of the notification section of the Athlete Notification copy of the Doping Control Form.

NOTE: This perforation is difficult to see. The top section of ‘Copy 1 – Athlete Notification – Orange’ should be handed to the Athlete. The remaining two blacked out sections should be torn off and discarded.

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7.1 Completing the Doping Control Form © WADA – DCO Manual - Version 3.0 – May 2011

Section 3. Information for Analysis If appropriate, the DCO shall complete the Test Mission Code

The DCO shall complete all information required including the Athlete’s

provided by the Sample Collection Authority.

gender, whether the test was conducted In-Competition or Out-Of-Competition, and the date/time

If no

of the test.

blood samples are to be collected, the N/A boxes

If no

should be checked and a line drawn through the section.

partial sample is collected, the N/A box

If a

should be checked and a line drawn through the section.

partial sample

The DCO shall complete the

is collected, insert the details. Both the DCO and Athlete will initial the Doping Control Form after each partial sample is sealed.

sample code numbers, volume of urine, time the sample was sealed and specific gravity

If no .

additional samples are collected, the N/A box

If

should be checked and a line drawn through the section.

more than one additional sample is collected, the DCO shall complete an additional Doping Control Form, completing all sections. A Supplementary Report Form shall be completed linking all the relevant sample code numbers. This Supplementary Report should be sent to the laboratory with the samples. The DCO must ensure that NO Athlete information

The DCO shall complete the is contained on this Supplementary Report Form.

Declaration of Medication Use and Blood Transfusions section of the form. If there is not enough space in this section, continue on a Supplementary Report Form and record the number of the Supplementary Form. The DCO must ensure that NO Athlete information

The Athlete shall complete the

is contained on this Supplementary Report Form

consent for research

section. The DCO shall explain to the Athlete that granting consent for research is optional, but that one of the boxes must be checked and the Athlete should sign his/her name.

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7.1 Completing the Doping Control Form © WADA – DCO Manual - Version 3.0 – May 2011

Section 4. Confirmation of Procedure The DCO shall ensure that: The Athlete is provided an opportunity to complete the Comments

The Witness to the urine sample provision

section. If there is insufficient space, continue on a Supplementary Report Form and record the number of the Supplementary Report Form. If the Athlete has no comments the Athlete or DCO will write “no comment”.

prints and signs his/her name (if there is more than one Witness, in the case of additional samples, both must sign the form. An explanation must be given in the DCO Report). If no additional samples have been collected, the N/A box should be checked and a line drawn through the section. The Blood Collection Officer prints and signs their name. If no blood samples have been collected, the DCO shall check the N/A box

The Athlete Representative and draw a line through the section.

prints and signs his/her name. If no Athlete Representative was present throughout the Sample Collection Process, the DCO shall check the N/A box

The DCO shall draw the Athlete’s attention to the text on the reverse of Page 1 of the form (i.e. Original copy), and ask him/her to read the information on Doping Control related data and the use of the ADAMS database.

and draw a line through the section.

The DCO should check the accuracy of the form, print and sign The DCO completes the

his/her name. date and time of completion

The Athlete should check the accuracy of the form, read the final statement and .

sign the form

.

NOTE: The Athlete should always be the last person to sign the form.

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7.1 Completing the Doping Control Form © WADA – DCO Manual - Version 3.0 – May 2011

Distribution of Copies of the Doping Control Form The DCO shall provide the Athlete with copy 2 (pink)

of the form.

NOTE: The Athlete should have already received his/her copy of the Athlete Notification Section of the Doping Control Form (Copy 1)

The DCO shall place copy 3 (blue) of the form with the samples to go to the laboratory. Please note that the laboratory copy no longer needs to be perforated before being sent to the laboratory. The whole of copy 3 (blue) should be sent with the samples to the laboratory

.

NOTE: The Athlete’s identity (i.e. names, initials) must not be included on the documentation sent to the laboratory.

If there is more than one laboratory (for e.g. if blood samples have been collected and are to be sent to an alternative laboratory for analysis), the DCO shall place the copy 4 (green) of the form with the samples to go to the second laboratory

.

The DCO shall return the original copy (white) and, if there is no second laboratory, copy 4 (green) to the Sample Collection Agency.

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TYPE OF TEST REQUIREDYTICYRTNUOCETADSIUQER ELÔRTNOC ED EPYTELLIV SYAP

GIVEN NAME FAMILY NAMEMONÉRP NOM DE FAMILLE

TROPS YTILANOITANNATIONALITÉ DISCIPLINE

ADDRESS ADRESSE

DOPING CONTROL FORMFORMULAIRE DE CONTRÔLE DU DOPAGE

1. ATHLETE INFORMATION • INFORMATION CONCERNANT LE SPORTIF

2. NOTIFICATION • NOTIFICATION

AAAA / YYYYMMJJ / DD

4. CONFIRMATION OF PROCEDURE FOR URINE AND/ 0R BLOOD TESTING • CONFIRMATION DE LA PROCÉDURE POUR LE CONTRÔLE D’URINE ET/OU DE SANGCOMMENTS: ANY COMMENTS SHOULD BE NOTED HERE. IF NECESSARY CONTINUE ON A SUPPLEMENTARY REPORT FORM.COMMENTAIRES: TOUS LES COMMENTAIRES DEVRAIENT ÊTRE INSCRITS ICI. AU BESOIN, UTILISER LE FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE.

I DECLARE THAT THE INFORMATION I HAVE GIVEN ON THIS DOCUMENT IS CORRECT. I DECLARE THAT, SUBJECT TO COMMENTS MADE IN SECTION 4, SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES FOR SAMPLE COLLECTION. I ACCEPT THAT ALL INFORMATIONRELATED TO DOPING CONTROL, INCLUDING BUT NOT LIMITED TO LABORATORY RESULTS AND POSSIBLE SANCTIONS, SHALL BE SHARED WITH RELEVANT BODIES IN ACCORDANCE WITH THE WORLD ANTI-DOPING CODE.I HAVE READ AND UNDERSTOOD THE TEXT OVERLEAF, AND I CONSENT TO THE PROCESSING OF MY PERSONAL DATA THROUGH ADAMS.

JE DÉCLARE QUE L'INFORMATION FOURNIE DANS CE DOCUMENT EST EXACTE. JE DÉCLARE, EN TENANT COMPTE DES COMMENTAIRES INSCRITS DANS LA SECTION 4, QUE LE PRÉLÈVEMENT D'ÉCHANTILLONS S’EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCEDURES APPLICABLES. J'ACCEPTE QUETOUTES LES INFORMATIONS RELATIVES AU CONTRÔLE DU DOPAGE, INCLUANT MAIS NON LIMITÉES AUX RÉSULTATS DE LABORATOIRE ET AUX SANCTIONS POSSIBLES, PUISSENT ÊTRE PARTAGÉES AVEC LES ORGANISATIONS CORRESPONDANTES SELON LE CODE MONDIAL ANTIDOPAGE.J'AI LU ET COMPRIS LE TEXTE AU VERSO ET JE CONSENS AU TRAITEMENT DE MES DONNEES PERSONNELLES PAR ADAMS.

02-2010 WADA/AMA :5 NOISREVLABORATORY - GREEN- 4 YPOCEULB - YROTAROBAL - 3 YPOCKNIP - ETELHTA - 2 YPOC ATHLETE NOTIFICATION - ORANGE - 1 YPOCETIHW - ODA -LANIGIROLABORATOIRE - VERT - 4 EIPOCUELB - ERIOTAROBAL- 3 EIPOCESOR - FITROPS - 2 EIPOCNOTIFICATION DU SPORTIF - ORANGE- 1 EIPOCCNALB - DAO - LANIGIRO

TEST AUTHORISED BY CONTRÔLE AUTORISÉ PAR

SAMPLE COLLECTION AUTHORITY AUTORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS

RESULTS MANAGEMENT AUTHORITY AUTORITÉ DE GESTION DES RESULTANTS

DATE OF BIRTH DATE DE NAISSANCE

ATHLETE ID PROVIDED?PIÈCE D’IDENTITÉ DU SPORTIF

YES • OUI NO • NON

DOCUMENT NUMBERNUMÉRO DE DOCUMENT

NUMBER/STREET • NUMÉRO/RUE CITY/TOWN • ETATSELLIV • PROVINCE

COUNTRY • PAYS CONTACT TEL (INCL. COUNTRY CODE)• TÉL CONTACT (INCL. CODE PAYS) E-MAIL • COURRIEL

DOCUMENT TYPETYPE DE DOCUMENT

( )

URINE BLOOD • SANG

TIMEHEURE

ATHLETE’S SIGNATURE • SIGNATURE DU SPORTIF

I HEREBY ACKNOWLEDGE THAT I HAVE RECEIVED AND READ THIS NOTICE, INCLUDING THE ATHLETE RIGHTS AND RESPONSIBILITIESTEXT ON THE OVERLEAF OF COPY 1, AND I CONSENT TO PROVIDE SAMPLE(S) AS REQUESTED (I UNDERSTAND THAT FAILURE ORREFUSAL TO PROVIDE A SAMPLE MAY CONSTITUTE AN ANTI-DOPING RULE VIOLATION).JE RECONNAIS AVOIR REÇU LU CET AVIS, Y COMPRIS LES DROITS ET LES RESPONSABILITÉS DU SPORTIF FIGURANT AU VERSO DE LA COPIE 1, ET JE CONSENS À FOURNIR L’(LES) ÉCHANTILLON(S) TEL(S)QUE REQUIS (JE COMPRENDS QUE LE REFUS OU LE FAIT DE MESOUSTRAIRE À FOURNIR UN ÉCHANTILLON CONSTITUE UNE VIOLATION DES RÈGLES ANTIDOPAGE).

TIME OF COMPLETION • COMPLÉTÉ À (HEURE)

DATE

DCO/CHAPERONE NAMENOM DE L’ACD/ESCORTE

DCO/CHAPERONE SIGNATURESIGNATURE DE

L’ACD/ESCORTE

ATHLETE’S SIGNATURESIGNATURE DU SPORTIF

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONALSAMPLE

ÉCHANTILLONADDITIONNEL

AAAA / YYYYMMJJ / DD

AAAA / YYYYMMJJ / DD

N / A

N / A

N / A

COACH’S NAME • NOM DE L’ENTRAÎNEUR DOCTOR’S NAME • NOM DU MÉDECIN

I CERTIFY THAT SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES• JE CERTIFIE PAR LA PRÉSENTE QUE LE PRÉLÈVEMENT D'ÉCHANTILLON S'EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCÉDURES APPLICABLESURINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE URINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE

NAME • NOM ERUTANGISMON • EMAN ERUTANGIS

BLOOD COLLECTION OFFICER • AGENT DE PRÉLÈVEMENT SANGUIN

NAME • NOM SIGNATURE

ATHLETE REPRESENTATIVE • REPRÉSENTANT DU SPORTIF

NAME • NOM ERUTANGISNOITCNOF • NOITISOP

DOPING CONTROL OFFICER • AGENT DE CONTRÔLE DU DOPAGE

NAME • NOM SIGNATURE

3. INFORMATION FOR ANALYSIS • INFORMATIONS CONCERNANT L’ANALYSE

AAAA / YYYYMMJJ / DD

DATE OF TESTDATE DU CONTRÔLE

DECLARATION OF MEDICATION USE AND BLOOD TRANSFUSIONS: LIST ANY PRESCRIPTION / NON-PRESCRIPTION MEDICATIONS OR SUPPLEMENTS, FOR E.G. BETA-2 AGONISTS AND GLUCOCORTICOSTEROIDS, TAKEN OVER THE PAST 7 DAYS (INCLUDE DOSAGE WHERE POSSIBLE) AND ANY TRANSFUSIONS RECEIVED OVER THE LAST SIX MONTHS.DECLARATION D’USAGE DE MÉDICAMENTS ET DE TRANSFUSIONS SANGUINES: INDIQUER LES MÉDICAMENTS PRESCRITS / NON PRESCRITS OU LES COMPLÉMENTS ALIMENTAIRES, Y COMPRIS PAR EXEMPLE, LES BÉTA-2 AGONISTES ET LES GLUCOCORTICOÏDES, PRIS AU COURS DES 7 DERNIERS JOURS (INDIQUER LA DOSE SI POSSIBLE)

M F

VOL. (ml)

GENDERSEXE

SPECIFIC GRAVITYDENSITÉ

1 0TIME SEALED • SCELLE A (HEURE) URINE SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON D’URINE

A/BURINE

VOL. (ml)SPECIFIC GRAVITY

DENSITÉ 1 0

TIME SEALED • SCELLE A (HEURE)

A/B

TEST MISSION CODE • CODE DE MISSION DE CONTRÔLE

PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml) PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml)

PARTIAL SAMPLE/ÉCHANTILLON

PARTIEL

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONAL SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON ADDITIONNEL

(ADDITIONAL SAMPLE • ÉCHANTILLON ADDITIONNEL)

CONSENT FOR RESEARCH (OPTIONAL) • CONSENTEMENT POUR LA RECHERCHE (OPTIONEL)IN ORDER TO HELP COMBAT DOPING IN SPORT, BY SIGNING BELOW I AGREE THAT MY SAMPLE MAY BE USED FOR ANTI-DOPING RESEARCH PURPOSES. WHEN ALL ANALYSES HAVE BEEN COMPLETED, AND MY SAMPLE WOULDOTHERWISE BE DISCARDED, IT MAY THEN BE USED BY ANY WADA-ACCREDITED LABORATORY FOR ANTI-DOPING RESEARCH OF ANY TYPE, PROVIDED THAT IT CAN NO LONGER BE IDENTIFIED AS MY SAMPLE. AFIN DE CONTRIBUER À LA LUTTE CONTRE LE DOPAGE DANS LE SPORT, J’ACCEPTE, EN SIGNANT CI-DESSOUS, QUE MON ÉCHANTILLON PUISSE ÊTRE UTILISÉ À DES FINS DE RECHERCHE ANTIDOPAGE. QUAND TOUTES LESANALYSES AURONT ÉTÉ EFFECTUÉES, ET ALORS QUE MON ÉCHANTILLON DEVRAIT NORMALEMENT ÊTRE DÉTRUIT, IL POURRA ALORS ÊTRE UTILISÉ PAR UN LABORATOIRE ACCRÉDITÉ PAR L’AMA À DES FINS DE RECHERCHEANTIDOPAGE DE TOUT TYPE, ÉTANT ENTENDU QU’IL NE POURRA PLUS ÊTRE IDENTIFIÉ COMME MON ÉCHANTILLON. SIGNATURE ____________________________________________________________

I ACCEPTJ’ACCEPTE

I REFUSEJE REFUSE

OUT OF COMPETITIONHORS COMPÉTITION

ARRIVAL TIME AT DOPING CONTROL STATIONHEURE D’ARRIVÉE À LA STATION DE CONTRÔLE DU DOPAGE

IN COMPETITIONEN COMPÉTITION

TIME • HEUREBLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/BBLOOD/SANG•

N/A

SAMPLE 1 • ÉCHANTILLON 1

N/A

SAMPLE 2 • ÉCHANTILLON 2

TIME • HEURE

N/A

BLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/B•

AINSI QUE TOUTE TRANSFUSION REÇUE AU COURS DES 6 DERNIERS MOIS.

FRON

T OF

ORI

GINA

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ATHLETE’S CONSENT FORMDoping Control-related Data

I am being asked to acknowledge that I know and adhere to my Anti-Doping Organization’s anti-doping Rules and that I undertake to abide by them. I am being asked to read the following formto ensure that I am aware that my doping control related data will be used in anti-doping programs for detection, deterrence and prevention of doping. Signing this form will indicate that Ihave been so informed and that I give my express consent to such processing.

I understand and agree that:

• My Doping Control related data will be used in the context of anti-doping programs and as described in more detail in the Athlete Information Notice made available to me by my sporting federation or national anti-doping organization and on the World Anti-Doping Agency (WADA) website;

• My Doping Control related data will be collected by the Testing Authority identified on this form, which shall be principally responsible for ensuring the protection of my data, and which is committed to complying with the International Standard for the Protection of Privacy and Personal Information;

• The Testing Authority will use the ADAMS data-management system to process and manage my Doping Control related data, and disclose it to authorized recipients, (for instance, designated national anti-doping organizations, international or national sporting federations, major games organizers, and WADA). WADA-accredited laboratories will also use ADAMS to process my laboratorytest results, but shall only have access to de-identified, key-coded data that will not disclose my identity;

• Persons or parties receiving my information may be located outside the country where I reside, including in Switzerland and Canada. In some other countries data protection and privacy laws may not be equivalent to those in my own country;

• Pursuant to the International standard referrenced above and under applicable law I have certain rights in relation to my Doping Control related data, including rights to access and/or correct any inaccurate data; and

• To the extent that I have any concerns about the processing of my Doping Control related data I may consult with the Testing Authority and/or WADA (www.wada-ama.org), as appropriate.

RELEASE

I hereby release WADA, as well as Anti-Doping Organizations and accredited laboratories from all claims, demands, liabilities, damages, costs and expenses that I may have arising in connection with theprocessing of my Doping Control related data through ADAMS.

WITHDRAWAL OF CONSENT

I understand that my participation in organized sporting events is contingent upon my voluntary participation in anti-doping procedures set forth in the Code and thus the processing of my Doping Controlrelated data as described in this form.

I understand that the withdrawal of my consent to the processing of my Doping Control related data will be construed as a refusal to participate in those anti-doping procedures mandated by the World Anti-Doping Code (the Code) and could exclude me from further participation in organized sporting events and may result in disciplinary or other sanctions being imposed upon me, such as disqualification fromcompetitions in which I am scheduled to participate or the invalidation of results arising from prior competitions.

AUTHORIZATION AND CONSENT

By signing this form, I hereby declare that I am familiar with and agree to abide by my Anti-Doping Organization’s Rules and that I expressly consent to the processing of my Doping Control related data asset forth above and in the Athlete Information Notice.

FORMULAIRE DE CONSENTEMENT DU SPORTIFDonnées relatives au contrôle du dopage

Je reconnais avoir pris connaissance des règles antidopage de mon organisation antidopage, je consens à y adhérer et je m’engage à les respecter.

Il m’est demandé de lire le formulaire ci-après afin de m’assurer que je suis informé que les données de contrôle du dopage me concernant seront utilisées dans des programmes de détection,de dissuasion et de prévention du dopage. Ma signature apposée au bas de ce formulaire attestera que j’ai bien été informé et que j’ai donné mon consentement exprès à un tel usage.

Je comprends et je conviens que :

• Les données relatives au contrôle du dopage me concernant seront utilisées dans le contexte de programmes antidopage et tel que décrit en détail dans la Notice d’information du sportif mise à ma disposition par ma fédération sportive ou mon organisation nationale antidopage et sur le site Web de l’Agence Mondiale Antidopage (l’AMA);

• Les données relatives au contrôle du dopage me concernant seront collectées par l’autorité responsable du contrôle identifiée dans ce formulaire; cette autorité aura la responsabilité d’assurer la protection de mes données et de se conformer au Standard international pour la protection des renseignements personnels;

• L’autorité responsable du contrôle utilisera le système de gestion des données ADAMS pour traiter et gérer les données relatives au contrôle du dopage me concernant, y compris leur communication aux destinataires autorisés (par exemple, organisations nationales antidopage désignées, fédérations nationales ou internationales sportives, organisateurs de grandes manifestations sportives et l’AMA). Les laboratoires accrédités par l’AMA auront également accès à des données non identifiées et codées qui ne dévoileront pas mon identité;

• Les personnes ou parties recevant les informations me concernant peuvent être situées hors du pays dans lequel je réside, y compris en Suisse et au Canada. Dans certains autres pays, la législation sur la protection des données et le droit au respect de la vie privée peut ne pas être équivalente à celle de mon propre pays;

• Conformément au Standard international nommé ci-dessus et en vertu des législations applicables, je dispose de droits en rapport avec les données du contrôle du dopage me concernant, notamment le droit d’accéder à mes données et de corriger toute inexactitude; et

• Dans le cas où je serais préoccupé par le traitement des données du contrôle du dopage me concernant, je peux consulter l’autorité responsable du contrôle ou l’AMA (www.wada-ama.org), selon le cas.

DÉCHARGE DE RESPONSABILITÉ

Je, soussigné, décharge l’AMA, ainsi que l’ensemble des organisations antidopage et laboratoires accrédités, de toute responsabilité en relation avec le traitement dans ADAMS des données relatives aucontrôle du dopage et renonce à toute prétention (dommage, coûts, dépenses) à cet égard.

RETRAIT DE CONSENTEMENT

Je comprends que ma participation à des manifestations sportives organisées est subordonnée à mon adhésion volontaire aux procédures antidopage fixées par le Code et dès lors au traitement des don-nées relatives au contrôle du dopage me concernant, tel que décrit dans ce formulaire.

Je comprends que le retrait de mon consentement au traitement des données relatives au contrôle du dopage me concernant sera considéré comme un refus de participer à ces procédures antidopagetelles qu’exigées par le Code mondial antidopage (le Code). Ceci pourrait entraîner mon exclusion de toute participation ultérieure à des manifestations sportives organisées et la prise de sanctions disci-plinaires ou autres à mon encontre, telles que disqualification des compétitions dans lesquelles ma participation est programmée ou invalidation des résultats obtenus dans des compétitions antérieures.

AUTORISATION ET CONSENTEMENT

En signant le présent formulaire, je consens expressément à l’utilisation des données relatives au contrôle du dopage me concernant telle que décrite ci-dessus et dans la Notice d’information du sportif.

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02-2010 WADA/AMA :5 NOISREVLABORATORY - GREEN- 4 YPOCEULB - YROTAROBAL - 3 YPOCKNIP - ETELHTA - 2 YPOC ATHLETE NOTIFICATION - ORANGE - 1 YPOCETIHW - ODA -LANIGIROLABORATOIRE - VERT - 4 EIPOCUELB - ERIOTAROBAL- 3 EIPOCESOR - FITROPS - 2 EIPOCNOTIFICATION DU SPORTIF - ORANGE- 1 EIPOCCNALB - DAO - LANIGIRO

3. INFORMATION FOR ANALYSIS • INFORMATIONS CONCERNANT L’ANALYSE

AAAA / YYYYMMJJ / DD

DATE OF TESTDATE DU CONTRÔLE

DECLARATION OF MEDICATION USE AND BLOOD TRANSFUSIONS: LIST ANY PRESCRIPTION / NON-PRESCRIPTION MEDICATIONS OR SUPPLEMENTS, FOR E.G. BETA-2 AGONISTS AND GLUCOCORTICOSTEROIDS, TAKEN OVER THE PAST 7 DAYS (INCLUDE DOSAGE WHERE POSSIBLE) AND ANY TRANSFUSIONS RECEIVED OVER THE LAST SIX MONTHS.DECLARATION D’USAGE DE MÉDICAMENTS ET DE TRANSFUSIONS SANGUINES: INDIQUER LES MÉDICAMENTS PRESCRITS / NON PRESCRITS OU LES COMPLÉMENTS ALIMENTAIRES, Y COMPRIS PAR EXEMPLE, LES BÉTA-2 AGONISTES ET LES GLUCOCORTICOÏDES, PRIS AU COURS DES 7 DERNIERS JOURS (INDIQUER LA DOSE SI POSSIBLE)

M F

VOL. (ml)

GENDERSEXE

SPECIFIC GRAVITYDENSITÉ

1 0TIME SEALED • SCELLE A (HEURE) URINE SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON D’URINE

A/BURINE

VOL. (ml)SPECIFIC GRAVITY

DENSITÉ 1 0

TIME SEALED • SCELLE A (HEURE)

A/B

TEST MISSION CODE • CODE DE MISSION DE CONTRÔLE

PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml) PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml)

PARTIAL SAMPLE/ÉCHANTILLON

PARTIEL

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONAL SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON ADDITIONNEL

(ADDITIONAL SAMPLE • ÉCHANTILLON ADDITIONNEL)

CONSENT FOR RESEARCH (OPTIONAL) • CONSENTEMENT POUR LA RECHERCHE (OPTIONEL)IN ORDER TO HELP COMBAT DOPING IN SPORT, BY SIGNING BELOW I AGREE THAT MY SAMPLE MAY BE USED FOR ANTI-DOPING RESEARCH PURPOSES. WHEN ALL ANALYSES HAVE BEEN COMPLETED, AND MY SAMPLE WOULDOTHERWISE BE DISCARDED, IT MAY THEN BE USED BY ANY WADA-ACCREDITED LABORATORY FOR ANTI-DOPING RESEARCH OF ANY TYPE, PROVIDED THAT IT CAN NO LONGER BE IDENTIFIED AS MY SAMPLE. AFIN DE CONTRIBUER À LA LUTTE CONTRE LE DOPAGE DANS LE SPORT, J’ACCEPTE, EN SIGNANT CI-DESSOUS, QUE MON ÉCHANTILLON PUISSE ÊTRE UTILISÉ À DES FINS DE RECHERCHE ANTIDOPAGE. QUAND TOUTES LESANALYSES AURONT ÉTÉ EFFECTUÉES, ET ALORS QUE MON ÉCHANTILLON DEVRAIT NORMALEMENT ÊTRE DÉTRUIT, IL POURRA ALORS ÊTRE UTILISÉ PAR UN LABORATOIRE ACCRÉDITÉ PAR L’AMA À DES FINS DE RECHERCHEANTIDOPAGE DE TOUT TYPE, ÉTANT ENTENDU QU’IL NE POURRA PLUS ÊTRE IDENTIFIÉ COMME MON ÉCHANTILLON. SIGNATURE ____________________________________________________________

I ACCEPTJ’ACCEPTE

I REFUSEJE REFUSE

OUT OF COMPETITIONHORS COMPÉTITION

ARRIVAL TIME AT DOPING CONTROL STATIONHEURE D’ARRIVÉE À LA STATION DE CONTRÔLE DU DOPAGE

IN COMPETITIONEN COMPÉTITION

TIME • HEUREBLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/BBLOOD/SANG•

N/A

SAMPLE 1 • ÉCHANTILLON 1

N/A

SAMPLE 2 • ÉCHANTILLON 2

TIME • HEURE

N/A

BLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/B•

AINSI QUE TOUTE TRANSFUSION REÇUE AU COURS DES 6 DERNIERS MOIS.

TYPE OF TEST REQUIREDYTICYRTNUOCETADSIUQER ELÔRTNOC ED EPYTELLIV SYAP

GIVEN NAME FAMILY NAMEMONÉRP NOM DE FAMILLE

TROPS YTILANOITANNATIONALITÉ DISCIPLINE

ADDRESS ADRESSE

DOPING CONTROL FORMFORMULAIRE DE CONTRÔLE DU DOPAGE

1. ATHLETE INFORMATION • INFORMATION CONCERNANT LE SPORTIF

2. NOTIFICATION • NOTIFICATION

AAAA / YYYYMMJJ / DD

4. CONFIRMATION OF PROCEDURE FOR URINE AND/ 0R BLOOD TESTING • CONFIRMATION DE LA PROCÉDURE POUR LE CONTRÔLE D’URINE ET/OU DE SANGCOMMENTS: ANY COMMENTS SHOULD BE NOTED HERE. IF NECESSARY CONTINUE ON A SUPPLEMENTARY REPORT FORM.COMMENTAIRES: TOUS LES COMMENTAIRES DEVRAIENT ÊTRE INSCRITS ICI. AU BESOIN, UTILISER LE FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE.

I DECLARE THAT THE INFORMATION I HAVE GIVEN ON THIS DOCUMENT IS CORRECT. I DECLARE THAT, SUBJECT TO COMMENTS MADE IN SECTION 4, SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES FOR SAMPLE COLLECTION. I ACCEPT THAT ALL INFORMATIONRELATED TO DOPING CONTROL, INCLUDING BUT NOT LIMITED TO LABORATORY RESULTS AND POSSIBLE SANCTIONS, SHALL BE SHARED WITH RELEVANT BODIES IN ACCORDANCE WITH THE WORLD ANTI-DOPING CODE.I HAVE READ AND UNDERSTOOD THE TEXT OVERLEAF, AND I CONSENT TO THE PROCESSING OF MY PERSONAL DATA THROUGH ADAMS.

JE DÉCLARE QUE L'INFORMATION FOURNIE DANS CE DOCUMENT EST EXACTE. JE DÉCLARE, EN TENANT COMPTE DES COMMENTAIRES INSCRITS DANS LA SECTION 4, QUE LE PRÉLÈVEMENT D'ÉCHANTILLONS S’EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCEDURES APPLICABLES. J'ACCEPTE QUETOUTES LES INFORMATIONS RELATIVES AU CONTRÔLE DU DOPAGE, INCLUANT MAIS NON LIMITÉES AUX RÉSULTATS DE LABORATOIRE ET AUX SANCTIONS POSSIBLES, PUISSENT ÊTRE PARTAGÉES AVEC LES ORGANISATIONS CORRESPONDANTES SELON LE CODE MONDIAL ANTIDOPAGE.J'AI LU ET COMPRIS LE TEXTE AU VERSO ET JE CONSENS AU TRAITEMENT DE MES DONNEES PERSONNELLES PAR ADAMS.

TEST AUTHORISED BY CONTRÔLE AUTORISÉ PAR

SAMPLE COLLECTION AUTHORITY AUTORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS

RESULTS MANAGEMENT AUTHORITY AUTORITÉ DE GESTION DES RESULTANTS

DATE OF BIRTH DATE DE NAISSANCE

ATHLETE ID PROVIDED?PIÈCE D’IDENTITÉ DU SPORTIF

YES • OUI NO • NON

DOCUMENT NUMBERNUMÉRO DE DOCUMENT

NUMBER/STREET • NUMÉRO/RUE CITY/TOWN • ETATSELLIV • PROVINCE

COUNTRY • PAYS CONTACT TEL (INCL. COUNTRY CODE)• TÉL CONTACT (INCL. CODE PAYS) E-MAIL • COURRIEL

DOCUMENT TYPETYPE DE DOCUMENT

( )

URINE BLOOD • SANG

TIMEHEURE

ATHLETE’S SIGNATURE • SIGNATURE DU SPORTIF

I HEREBY ACKNOWLEDGE THAT I HAVE RECEIVED AND READ THIS NOTICE, INCLUDING THE ATHLETE RIGHTS AND RESPONSIBILITIESTEXT ON THE OVERLEAF OF COPY 1, AND I CONSENT TO PROVIDE SAMPLE(S) AS REQUESTED (I UNDERSTAND THAT FAILURE ORREFUSAL TO PROVIDE A SAMPLE MAY CONSTITUTE AN ANTI-DOPING RULE VIOLATION).JE RECONNAIS AVOIR REÇU LU CET AVIS, Y COMPRIS LES DROITS ET LES RESPONSABILITÉS DU SPORTIF FIGURANT AU VERSO DE LA COPIE 1, ET JE CONSENS À FOURNIR L’(LES) ÉCHANTILLON(S) TEL(S)QUE REQUIS (JE COMPRENDS QUE LE REFUS OU LE FAIT DE MESOUSTRAIRE À FOURNIR UN ÉCHANTILLON CONSTITUE UNE VIOLATION DES RÈGLES ANTIDOPAGE).

TIME OF COMPLETION • COMPLÉTÉ À (HEURE)

DATE

DCO/CHAPERONE NAMENOM DE L’ACD/ESCORTE

DCO/CHAPERONE SIGNATURESIGNATURE DE

L’ACD/ESCORTE

ATHLETE’S SIGNATURESIGNATURE DU SPORTIF

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONALSAMPLE

ÉCHANTILLONADDITIONNEL

AAAA / YYYYMMJJ / DD

AAAA / YYYYMMJJ / DD

N / A

N / A

N / A

COACH’S NAME • NOM DE L’ENTRAÎNEUR DOCTOR’S NAME • NOM DU MÉDECIN

I CERTIFY THAT SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES• JE CERTIFIE PAR LA PRÉSENTE QUE LE PRÉLÈVEMENT D'ÉCHANTILLON S'EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCÉDURES APPLICABLESURINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE URINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE

NAME • NOM ERUTANGISMON • EMAN ERUTANGIS

BLOOD COLLECTION OFFICER • AGENT DE PRÉLÈVEMENT SANGUIN

NAME • NOM SIGNATURE

ATHLETE REPRESENTATIVE • REPRÉSENTANT DU SPORTIF

NAME • NOM ERUTANGISNOITCNOF • NOITISOP

DOPING CONTROL OFFICER • AGENT DE CONTRÔLE DU DOPAGE

NAME • NOM SIGNATURE

FRON

T OF

COP

Y 1

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Athlete Rights – you have the right to:

• Have a representative and if available, an interpreter.• Ask for additional information about the Sample collection process.• Request a delay in reporting to the Doping Control Station for valid reasons (as

determined by the Doping Control Officer).• If you are an athlete with a disability, request modifications to the Sample collection

procedure.

Athlete Responsibilities – you have the responsibility to:

• Remain within direct observation of the DCO/Chaperone at all times from the point of notification by the DCO/Chaperone until the completion of the Sample collection procedure.

• Produce appropriate identification.• Comply with Sample collection procedures – failure to do so may constitute an Anti-

Doping Rule Violation.• Report immediately for a test, unless there are valid reasons for a delay.

Athlete Rights and Responsibilities

Les Droits du Sportif – vos droits sont les suivants :

• Avoir un représentant et, si disponible, un interprète.• Obtenir de plus amples renseignements sur le processus de prélèvement d’échantillons• Demander un délai pour se présenter au poste de contrôle du dopage pour les raisons

valables (tel que détérminé par votre agent de contrôle du dopage).• Si vous etes un sportif avec handicap, demander des modifications aux procedures de

prevelement d’enchantillons.

Les Responsabilités du Sportif – vos responsabilités sont les suivantes :

• Demeurer sous observation directe de l’ACD/escorte en permanence à compter du moment de la notification par l’ACD/escorte, jusqu’à ce que la procédure de prélèvement d’échantillons soit terminée.

• Fournir une preuve d’identité officielle et valide.• Se conformer aux procédures de prélèvement d’échantillons – tout manquement pourrait

constituer une violation des règles antidopage.• Se présenter immédiatement pour le contrôle, à moins d’être retardé pour des raisons valables.

Les Droits et Responsabilités du Sportif

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TYPE OF TEST REQUIREDYTICYRTNUOCETADSIUQER ELÔRTNOC ED EPYTELLIV SYAP

GIVEN NAME FAMILY NAMEMONÉRP NOM DE FAMILLE

TROPS YTILANOITANNATIONALITÉ DISCIPLINE

ADDRESS ADRESSE

DOPING CONTROL FORMFORMULAIRE DE CONTRÔLE DU DOPAGE

1. ATHLETE INFORMATION • INFORMATION CONCERNANT LE SPORTIF

2. NOTIFICATION • NOTIFICATION

AAAA / YYYYMMJJ / DD

4. CONFIRMATION OF PROCEDURE FOR URINE AND/ 0R BLOOD TESTING • CONFIRMATION DE LA PROCÉDURE POUR LE CONTRÔLE D’URINE ET/OU DE SANGCOMMENTS: ANY COMMENTS SHOULD BE NOTED HERE. IF NECESSARY CONTINUE ON A SUPPLEMENTARY REPORT FORM.COMMENTAIRES: TOUS LES COMMENTAIRES DEVRAIENT ÊTRE INSCRITS ICI. AU BESOIN, UTILISER LE FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE.

I DECLARE THAT THE INFORMATION I HAVE GIVEN ON THIS DOCUMENT IS CORRECT. I DECLARE THAT, SUBJECT TO COMMENTS MADE IN SECTION 4, SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES FOR SAMPLE COLLECTION. I ACCEPT THAT ALL INFORMATIONRELATED TO DOPING CONTROL, INCLUDING BUT NOT LIMITED TO LABORATORY RESULTS AND POSSIBLE SANCTIONS, SHALL BE SHARED WITH RELEVANT BODIES IN ACCORDANCE WITH THE WORLD ANTI-DOPING CODE.I HAVE READ AND UNDERSTOOD THE TEXT OVERLEAF, AND I CONSENT TO THE PROCESSING OF MY PERSONAL DATA THROUGH ADAMS.

JE DÉCLARE QUE L'INFORMATION FOURNIE DANS CE DOCUMENT EST EXACTE. JE DÉCLARE, EN TENANT COMPTE DES COMMENTAIRES INSCRITS DANS LA SECTION 4, QUE LE PRÉLÈVEMENT D'ÉCHANTILLONS S’EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCEDURES APPLICABLES. J'ACCEPTE QUETOUTES LES INFORMATIONS RELATIVES AU CONTRÔLE DU DOPAGE, INCLUANT MAIS NON LIMITÉES AUX RÉSULTATS DE LABORATOIRE ET AUX SANCTIONS POSSIBLES, PUISSENT ÊTRE PARTAGÉES AVEC LES ORGANISATIONS CORRESPONDANTES SELON LE CODE MONDIAL ANTIDOPAGE.J'AI LU ET COMPRIS LE TEXTE AU VERSO ET JE CONSENS AU TRAITEMENT DE MES DONNEES PERSONNELLES PAR ADAMS.

02-2010 WADA/AMA :5 NOISREVLABORATORY - GREEN- 4 YPOCEULB - YROTAROBAL - 3 YPOCKNIP - ETELHTA - 2 YPOC ATHLETE NOTIFICATION - ORANGE - 1 YPOCETIHW - ODA -LANIGIROLABORATOIRE - VERT - 4 EIPOCUELB - ERIOTAROBAL- 3 EIPOCESOR - FITROPS - 2 EIPOCNOTIFICATION DU SPORTIF - ORANGE- 1 EIPOCCNALB - DAO - LANIGIRO

TEST AUTHORISED BY CONTRÔLE AUTORISÉ PAR

SAMPLE COLLECTION AUTHORITY AUTORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS

RESULTS MANAGEMENT AUTHORITY AUTORITÉ DE GESTION DES RESULTANTS

DATE OF BIRTH DATE DE NAISSANCE

ATHLETE ID PROVIDED?PIÈCE D’IDENTITÉ DU SPORTIF

YES • OUI NO • NON

DOCUMENT NUMBERNUMÉRO DE DOCUMENT

NUMBER/STREET • NUMÉRO/RUE CITY/TOWN • ETATSELLIV • PROVINCE

COUNTRY • PAYS CONTACT TEL (INCL. COUNTRY CODE)• TÉL CONTACT (INCL. CODE PAYS) E-MAIL • COURRIEL

DOCUMENT TYPETYPE DE DOCUMENT

( )

URINE BLOOD • SANG

TIMEHEURE

ATHLETE’S SIGNATURE • SIGNATURE DU SPORTIF

I HEREBY ACKNOWLEDGE THAT I HAVE RECEIVED AND READ THIS NOTICE, INCLUDING THE ATHLETE RIGHTS AND RESPONSIBILITIESTEXT ON THE OVERLEAF OF COPY 1, AND I CONSENT TO PROVIDE SAMPLE(S) AS REQUESTED (I UNDERSTAND THAT FAILURE ORREFUSAL TO PROVIDE A SAMPLE MAY CONSTITUTE AN ANTI-DOPING RULE VIOLATION).JE RECONNAIS AVOIR REÇU LU CET AVIS, Y COMPRIS LES DROITS ET LES RESPONSABILITÉS DU SPORTIF FIGURANT AU VERSO DE LA COPIE 1, ET JE CONSENS À FOURNIR L’(LES) ÉCHANTILLON(S) TEL(S)QUE REQUIS (JE COMPRENDS QUE LE REFUS OU LE FAIT DE MESOUSTRAIRE À FOURNIR UN ÉCHANTILLON CONSTITUE UNE VIOLATION DES RÈGLES ANTIDOPAGE).

TIME OF COMPLETION • COMPLÉTÉ À (HEURE)

DATE

DCO/CHAPERONE NAMENOM DE L’ACD/ESCORTE

DCO/CHAPERONE SIGNATURESIGNATURE DE

L’ACD/ESCORTE

ATHLETE’S SIGNATURESIGNATURE DU SPORTIF

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONALSAMPLE

ÉCHANTILLONADDITIONNEL

AAAA / YYYYMMJJ / DD

AAAA / YYYYMMJJ / DD

N / A

N / A

N / A

COACH’S NAME • NOM DE L’ENTRAÎNEUR DOCTOR’S NAME • NOM DU MÉDECIN

I CERTIFY THAT SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES• JE CERTIFIE PAR LA PRÉSENTE QUE LE PRÉLÈVEMENT D'ÉCHANTILLON S'EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCÉDURES APPLICABLESURINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE URINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE

NAME • NOM ERUTANGISMON • EMAN ERUTANGIS

BLOOD COLLECTION OFFICER • AGENT DE PRÉLÈVEMENT SANGUIN

NAME • NOM SIGNATURE

ATHLETE REPRESENTATIVE • REPRÉSENTANT DU SPORTIF

NAME • NOM ERUTANGISNOITCNOF • NOITISOP

DOPING CONTROL OFFICER • AGENT DE CONTRÔLE DU DOPAGE

NAME • NOM SIGNATURE

3. INFORMATION FOR ANALYSIS • INFORMATIONS CONCERNANT L’ANALYSE

AAAA / YYYYMMJJ / DD

DATE OF TESTDATE DU CONTRÔLE

DECLARATION OF MEDICATION USE AND BLOOD TRANSFUSIONS: LIST ANY PRESCRIPTION / NON-PRESCRIPTION MEDICATIONS OR SUPPLEMENTS, FOR E.G. BETA-2 AGONISTS AND GLUCOCORTICOSTEROIDS, TAKEN OVER THE PAST 7 DAYS (INCLUDE DOSAGE WHERE POSSIBLE) AND ANY TRANSFUSIONS RECEIVED OVER THE LAST SIX MONTHS.DECLARATION D’USAGE DE MÉDICAMENTS ET DE TRANSFUSIONS SANGUINES: INDIQUER LES MÉDICAMENTS PRESCRITS / NON PRESCRITS OU LES COMPLÉMENTS ALIMENTAIRES, Y COMPRIS PAR EXEMPLE, LES BÉTA-2 AGONISTES ET LES GLUCOCORTICOÏDES, PRIS AU COURS DES 7 DERNIERS JOURS (INDIQUER LA DOSE SI POSSIBLE)

M F

VOL. (ml)

GENDERSEXE

SPECIFIC GRAVITYDENSITÉ

1 0TIME SEALED • SCELLE A (HEURE) URINE SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON D’URINE

A/BURINE

VOL. (ml)SPECIFIC GRAVITY

DENSITÉ 1 0

TIME SEALED • SCELLE A (HEURE)

A/B

TEST MISSION CODE • CODE DE MISSION DE CONTRÔLE

PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml) PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml)

PARTIAL SAMPLE/ÉCHANTILLON

PARTIEL

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONAL SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON ADDITIONNEL

(ADDITIONAL SAMPLE • ÉCHANTILLON ADDITIONNEL)

CONSENT FOR RESEARCH (OPTIONAL) • CONSENTEMENT POUR LA RECHERCHE (OPTIONEL)IN ORDER TO HELP COMBAT DOPING IN SPORT, BY SIGNING BELOW I AGREE THAT MY SAMPLE MAY BE USED FOR ANTI-DOPING RESEARCH PURPOSES. WHEN ALL ANALYSES HAVE BEEN COMPLETED, AND MY SAMPLE WOULDOTHERWISE BE DISCARDED, IT MAY THEN BE USED BY ANY WADA-ACCREDITED LABORATORY FOR ANTI-DOPING RESEARCH OF ANY TYPE, PROVIDED THAT IT CAN NO LONGER BE IDENTIFIED AS MY SAMPLE. AFIN DE CONTRIBUER À LA LUTTE CONTRE LE DOPAGE DANS LE SPORT, J’ACCEPTE, EN SIGNANT CI-DESSOUS, QUE MON ÉCHANTILLON PUISSE ÊTRE UTILISÉ À DES FINS DE RECHERCHE ANTIDOPAGE. QUAND TOUTES LESANALYSES AURONT ÉTÉ EFFECTUÉES, ET ALORS QUE MON ÉCHANTILLON DEVRAIT NORMALEMENT ÊTRE DÉTRUIT, IL POURRA ALORS ÊTRE UTILISÉ PAR UN LABORATOIRE ACCRÉDITÉ PAR L’AMA À DES FINS DE RECHERCHEANTIDOPAGE DE TOUT TYPE, ÉTANT ENTENDU QU’IL NE POURRA PLUS ÊTRE IDENTIFIÉ COMME MON ÉCHANTILLON. SIGNATURE ____________________________________________________________

I ACCEPTJ’ACCEPTE

I REFUSEJE REFUSE

OUT OF COMPETITIONHORS COMPÉTITION

ARRIVAL TIME AT DOPING CONTROL STATIONHEURE D’ARRIVÉE À LA STATION DE CONTRÔLE DU DOPAGE

IN COMPETITIONEN COMPÉTITION

TIME • HEUREBLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/BBLOOD/SANG•

N/A

SAMPLE 1 • ÉCHANTILLON 1

N/A

SAMPLE 2 • ÉCHANTILLON 2

TIME • HEURE

N/A

BLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/B•

AINSI QUE TOUTE TRANSFUSION REÇUE AU COURS DES 6 DERNIERS MOIS.

FRON

T OF

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ATHLETE’S CONSENT FORMDoping Control-related Data

I am being asked to acknowledge that I know and adhere to my Anti-Doping Organization’s anti-doping Rules and that I undertake to abide by them. I am being asked to read the following formto ensure that I am aware that my doping control related data will be used in anti-doping programs for detection, deterrence and prevention of doping. Signing this form will indicate that Ihave been so informed and that I give my express consent to such processing.

I understand and agree that:

• My Doping Control related data will be used in the context of anti-doping programs and as described in more detail in the Athlete Information Notice made available to me by my sporting federation or national anti-doping organization and on the World Anti-Doping Agency (WADA) website;

• My Doping Control related data will be collected by the Testing Authority identified on this form, which shall be principally responsible for ensuring the protection of my data, and which is committed to complying with the International Standard for the Protection of Privacy and Personal Information;

• The Testing Authority will use the ADAMS data-management system to process and manage my Doping Control related data, and disclose it to authorized recipients, (for instance, designated national anti-doping organizations, international or national sporting federations, major games organizers, and WADA). WADA-accredited laboratories will also use ADAMS to process my laboratorytest results, but shall only have access to de-identified, key-coded data that will not disclose my identity;

• Persons or parties receiving my information may be located outside the country where I reside, including in Switzerland and Canada. In some other countries data protection and privacy laws may not be equivalent to those in my own country;

• Pursuant to the International standard referrenced above and under applicable law I have certain rights in relation to my Doping Control related data, including rights to access and/or correct any inaccurate data; and

• To the extent that I have any concerns about the processing of my Doping Control related data I may consult with the Testing Authority and/or WADA (www.wada-ama.org), as appropriate.

RELEASE

I hereby release WADA, as well as Anti-Doping Organizations and accredited laboratories from all claims, demands, liabilities, damages, costs and expenses that I may have arising in connection with theprocessing of my Doping Control related data through ADAMS.

WITHDRAWAL OF CONSENT

I understand that my participation in organized sporting events is contingent upon my voluntary participation in anti-doping procedures set forth in the Code and thus the processing of my Doping Controlrelated data as described in this form.

I understand that the withdrawal of my consent to the processing of my Doping Control related data will be construed as a refusal to participate in those anti-doping procedures mandated by the World Anti-Doping Code (the Code) and could exclude me from further participation in organized sporting events and may result in disciplinary or other sanctions being imposed upon me, such as disqualification fromcompetitions in which I am scheduled to participate or the invalidation of results arising from prior competitions.

AUTHORIZATION AND CONSENT

By signing this form, I hereby declare that I am familiar with and agree to abide by my Anti-Doping Organization’s Rules and that I expressly consent to the processing of my Doping Control related data asset forth above and in the Athlete Information Notice.

FORMULAIRE DE CONSENTEMENT DU SPORTIFDonnées relatives au contrôle du dopage

Je reconnais avoir pris connaissance des règles antidopage de mon organisation antidopage, je consens à y adhérer et je m’engage à les respecter.

Il m’est demandé de lire le formulaire ci-après afin de m’assurer que je suis informé que les données de contrôle du dopage me concernant seront utilisées dans des programmes de détection,de dissuasion et de prévention du dopage. Ma signature apposée au bas de ce formulaire attestera que j’ai bien été informé et que j’ai donné mon consentement exprès à un tel usage.

Je comprends et je conviens que :

• Les données relatives au contrôle du dopage me concernant seront utilisées dans le contexte de programmes antidopage et tel que décrit en détail dans la Notice d’information du sportif mise à ma disposition par ma fédération sportive ou mon organisation nationale antidopage et sur le site Web de l’Agence Mondiale Antidopage (l’AMA);

• Les données relatives au contrôle du dopage me concernant seront collectées par l’autorité responsable du contrôle identifiée dans ce formulaire; cette autorité aura la responsabilité d’assurer la protection de mes données et de se conformer au Standard international pour la protection des renseignements personnels;

• L’autorité responsable du contrôle utilisera le système de gestion des données ADAMS pour traiter et gérer les données relatives au contrôle du dopage me concernant, y compris leur communication aux destinataires autorisés (par exemple, organisations nationales antidopage désignées, fédérations nationales ou internationales sportives, organisateurs de grandes manifestations sportives et l’AMA). Les laboratoires accrédités par l’AMA auront également accès à des données non identifiées et codées qui ne dévoileront pas mon identité;

• Les personnes ou parties recevant les informations me concernant peuvent être situées hors du pays dans lequel je réside, y compris en Suisse et au Canada. Dans certains autres pays, la législation sur la protection des données et le droit au respect de la vie privée peut ne pas être équivalente à celle de mon propre pays;

• Conformément au Standard international nommé ci-dessus et en vertu des législations applicables, je dispose de droits en rapport avec les données du contrôle du dopage me concernant, notamment le droit d’accéder à mes données et de corriger toute inexactitude; et

• Dans le cas où je serais préoccupé par le traitement des données du contrôle du dopage me concernant, je peux consulter l’autorité responsable du contrôle ou l’AMA (www.wada-ama.org), selon le cas.

DÉCHARGE DE RESPONSABILITÉ

Je, soussigné, décharge l’AMA, ainsi que l’ensemble des organisations antidopage et laboratoires accrédités, de toute responsabilité en relation avec le traitement dans ADAMS des données relatives aucontrôle du dopage et renonce à toute prétention (dommage, coûts, dépenses) à cet égard.

RETRAIT DE CONSENTEMENT

Je comprends que ma participation à des manifestations sportives organisées est subordonnée à mon adhésion volontaire aux procédures antidopage fixées par le Code et dès lors au traitement des don-nées relatives au contrôle du dopage me concernant, tel que décrit dans ce formulaire.

Je comprends que le retrait de mon consentement au traitement des données relatives au contrôle du dopage me concernant sera considéré comme un refus de participer à ces procédures antidopagetelles qu’exigées par le Code mondial antidopage (le Code). Ceci pourrait entraîner mon exclusion de toute participation ultérieure à des manifestations sportives organisées et la prise de sanctions disci-plinaires ou autres à mon encontre, telles que disqualification des compétitions dans lesquelles ma participation est programmée ou invalidation des résultats obtenus dans des compétitions antérieures.

AUTORISATION ET CONSENTEMENT

En signant le présent formulaire, je consens expressément à l’utilisation des données relatives au contrôle du dopage me concernant telle que décrite ci-dessus et dans la Notice d’information du sportif.

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3. INFORMATION FOR ANALYSIS • INFORMATIONS CONCERNANT L’ANALYSE

AAAA / YYYYMMJJ / DD

DATE OF TESTDATE DU CONTRÔLE

DECLARATION OF MEDICATION USE AND BLOOD TRANSFUSIONS: LIST ANY PRESCRIPTION / NON-PRESCRIPTION MEDICATIONS OR SUPPLEMENTS, FOR E.G. BETA-2 AGONISTS AND GLUCOCORTICOSTEROIDS, TAKEN OVER THE PAST 7 DAYS (INCLUDE DOSAGE WHERE POSSIBLE) AND ANY TRANSFUSIONS RECEIVED OVER THE LAST SIX MONTHS.DECLARATION D’USAGE DE MÉDICAMENTS ET DE TRANSFUSIONS SANGUINES: INDIQUER LES MÉDICAMENTS PRESCRITS / NON PRESCRITS OU LES COMPLÉMENTS ALIMENTAIRES, Y COMPRIS PAR EXEMPLE, LES BÉTA-2 AGONISTES ET LES GLUCOCORTICOÏDES, PRIS AU COURS DES 7 DERNIERS JOURS (INDIQUER LA DOSE SI POSSIBLE)

M F

VOL. (ml)

GENDERSEXE

SPECIFIC GRAVITYDENSITÉ

1 0TIME SEALED • SCELLE A (HEURE) URINE SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON D’URINE

A/BURINE

VOL. (ml)SPECIFIC GRAVITY

DENSITÉ 1 0

TIME SEALED • SCELLE A (HEURE)

A/B

TEST MISSION CODE • CODE DE MISSION DE CONTRÔLE

PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml) PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml)

PARTIAL SAMPLE/ÉCHANTILLON

PARTIEL

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONAL SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON ADDITIONNEL

(ADDITIONAL SAMPLE • ÉCHANTILLON ADDITIONNEL)

CONSENT FOR RESEARCH (OPTIONAL) • CONSENTEMENT POUR LA RECHERCHE (OPTIONEL)IN ORDER TO HELP COMBAT DOPING IN SPORT, BY SIGNING BELOW I AGREE THAT MY SAMPLE MAY BE USED FOR ANTI-DOPING RESEARCH PURPOSES. WHEN ALL ANALYSES HAVE BEEN COMPLETED, AND MY SAMPLE WOULDOTHERWISE BE DISCARDED, IT MAY THEN BE USED BY ANY WADA-ACCREDITED LABORATORY FOR ANTI-DOPING RESEARCH OF ANY TYPE, PROVIDED THAT IT CAN NO LONGER BE IDENTIFIED AS MY SAMPLE. AFIN DE CONTRIBUER À LA LUTTE CONTRE LE DOPAGE DANS LE SPORT, J’ACCEPTE, EN SIGNANT CI-DESSOUS, QUE MON ÉCHANTILLON PUISSE ÊTRE UTILISÉ À DES FINS DE RECHERCHE ANTIDOPAGE. QUAND TOUTES LESANALYSES AURONT ÉTÉ EFFECTUÉES, ET ALORS QUE MON ÉCHANTILLON DEVRAIT NORMALEMENT ÊTRE DÉTRUIT, IL POURRA ALORS ÊTRE UTILISÉ PAR UN LABORATOIRE ACCRÉDITÉ PAR L’AMA À DES FINS DE RECHERCHEANTIDOPAGE DE TOUT TYPE, ÉTANT ENTENDU QU’IL NE POURRA PLUS ÊTRE IDENTIFIÉ COMME MON ÉCHANTILLON. SIGNATURE ____________________________________________________________

I ACCEPTJ’ACCEPTE

I REFUSEJE REFUSE

OUT OF COMPETITIONHORS COMPÉTITION

ARRIVAL TIME AT DOPING CONTROL STATIONHEURE D’ARRIVÉE À LA STATION DE CONTRÔLE DU DOPAGE

IN COMPETITIONEN COMPÉTITION

TIME • HEUREBLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/BBLOOD/SANG•

N/A

SAMPLE 1 • ÉCHANTILLON 1

N/A

SAMPLE 2 • ÉCHANTILLON 2

TIME • HEURE

N/A

BLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/B•

AINSI QUE TOUTE TRANSFUSION REÇUE AU COURS DES 6 DERNIERS MOIS.

TYPE OF TEST REQUIREDYTICYRTNUOCETADSIUQER ELÔRTNOC ED EPYTELLIV SYAP

GIVEN NAME FAMILY NAMEMONÉRP NOM DE FAMILLE

TROPS YTILANOITANNATIONALITÉ DISCIPLINE

ADDRESS ADRESSE

DOPING CONTROL FORMFORMULAIRE DE CONTRÔLE DU DOPAGE

1. ATHLETE INFORMATION • INFORMATION CONCERNANT LE SPORTIF

2. NOTIFICATION • NOTIFICATION

AAAA / YYYYMMJJ / DD

4. CONFIRMATION OF PROCEDURE FOR URINE AND/ 0R BLOOD TESTING • CONFIRMATION DE LA PROCÉDURE POUR LE CONTRÔLE D’URINE ET/OU DE SANGCOMMENTS: ANY COMMENTS SHOULD BE NOTED HERE. IF NECESSARY CONTINUE ON A SUPPLEMENTARY REPORT FORM.COMMENTAIRES: TOUS LES COMMENTAIRES DEVRAIENT ÊTRE INSCRITS ICI. AU BESOIN, UTILISER LE FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE.

I DECLARE THAT THE INFORMATION I HAVE GIVEN ON THIS DOCUMENT IS CORRECT. I DECLARE THAT, SUBJECT TO COMMENTS MADE IN SECTION 4, SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES FOR SAMPLE COLLECTION. I ACCEPT THAT ALL INFORMATIONRELATED TO DOPING CONTROL, INCLUDING BUT NOT LIMITED TO LABORATORY RESULTS AND POSSIBLE SANCTIONS, SHALL BE SHARED WITH RELEVANT BODIES IN ACCORDANCE WITH THE WORLD ANTI-DOPING CODE.I HAVE READ AND UNDERSTOOD THE TEXT OVERLEAF, AND I CONSENT TO THE PROCESSING OF MY PERSONAL DATA THROUGH ADAMS.

JE DÉCLARE QUE L'INFORMATION FOURNIE DANS CE DOCUMENT EST EXACTE. JE DÉCLARE, EN TENANT COMPTE DES COMMENTAIRES INSCRITS DANS LA SECTION 4, QUE LE PRÉLÈVEMENT D'ÉCHANTILLONS S’EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCEDURES APPLICABLES. J'ACCEPTE QUETOUTES LES INFORMATIONS RELATIVES AU CONTRÔLE DU DOPAGE, INCLUANT MAIS NON LIMITÉES AUX RÉSULTATS DE LABORATOIRE ET AUX SANCTIONS POSSIBLES, PUISSENT ÊTRE PARTAGÉES AVEC LES ORGANISATIONS CORRESPONDANTES SELON LE CODE MONDIAL ANTIDOPAGE.J'AI LU ET COMPRIS LE TEXTE AU VERSO ET JE CONSENS AU TRAITEMENT DE MES DONNEES PERSONNELLES PAR ADAMS.

TEST AUTHORISED BY CONTRÔLE AUTORISÉ PAR

SAMPLE COLLECTION AUTHORITY AUTORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS

RESULTS MANAGEMENT AUTHORITY AUTORITÉ DE GESTION DES RESULTANTS

DATE OF BIRTH DATE DE NAISSANCE

ATHLETE ID PROVIDED?PIÈCE D’IDENTITÉ DU SPORTIF

YES • OUI NO • NON

DOCUMENT NUMBERNUMÉRO DE DOCUMENT

NUMBER/STREET • NUMÉRO/RUE CITY/TOWN • ETATSELLIV • PROVINCE

COUNTRY • PAYS CONTACT TEL (INCL. COUNTRY CODE)• TÉL CONTACT (INCL. CODE PAYS) E-MAIL • COURRIEL

DOCUMENT TYPETYPE DE DOCUMENT

( )

URINE BLOOD • SANG

TIMEHEURE

ATHLETE’S SIGNATURE • SIGNATURE DU SPORTIF

I HEREBY ACKNOWLEDGE THAT I HAVE RECEIVED AND READ THIS NOTICE, INCLUDING THE ATHLETE RIGHTS AND RESPONSIBILITIESTEXT ON THE OVERLEAF OF COPY 4, AND I CONSENT TO PROVIDE SAMPLE(S) AS REQUESTED (I UNDERSTAND THAT FAILURE ORREFUSAL TO PROVIDE A SAMPLE MAY CONSTITUTE AN ANTI-DOPING RULE VIOLATION).JE RECONNAIS AVOIR REÇU LU CET AVIS, Y COMPRIS LES DROITS ET LES RESPONSABILITÉS DU SPORTIF FIGURANT AU VERSO DE LA COPIE 4, ET JE CONSENS À FOURNIR L’(LES) ÉCHANTILLON(S) TEL(S)QUE REQUIS (JE COMPRENDS QUE LE REFUS OU LE FAIT DE MESOUSTRAIRE À FOURNIR UN ÉCHANTILLON CONSTITUE UNE VIOLATION DES RÈGLES ANTIDOPAGE).

TIME OF COMPLETION • COMPLÉTÉ À (HEURE)

DATE

DCO/CHAPERONE NAMENOM DE L’ACD/ESCORTE

DCO/CHAPERONE SIGNATURESIGNATURE DE

L’ACD/ESCORTE

ATHLETE’S SIGNATURESIGNATURE DU SPORTIF

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONALSAMPLE

ÉCHANTILLONADDITIONNEL

AAAA / YYYYMMJJ / DD

AAAA / YYYYMMJJ / DD

N / A

N / A

N / A

COACH’S NAME • NOM DE L’ENTRAÎNEUR DOCTOR’S NAME • NOM DU MÉDECIN

I CERTIFY THAT SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES• JE CERTIFIE PAR LA PRÉSENTE QUE LE PRÉLÈVEMENT D'ÉCHANTILLON S'EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCÉDURES APPLICABLESURINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE URINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE

NAME • NOM ERUTANGISMON • EMAN ERUTANGIS

BLOOD COLLECTION OFFICER • AGENT DE PRÉLÈVEMENT SANGUIN

NAME • NOM SIGNATURE

ATHLETE REPRESENTATIVE • REPRÉSENTANT DU SPORTIF

NAME • NOM ERUTANGISNOITCNOF • NOITISOP

DOPING CONTROL OFFICER • AGENT DE CONTRÔLE DU DOPAGE

NAME • NOM SIGNATURE

FRON

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02-2010 WADA/AMA :5 NOISREVLABORATORY - GREEN- 4 YPOCEULB - YROTAROBAL - 3 YPOCKNIP - ETELHTA - 2 YPOC ATHLETE NOTIFICATION - ORANGE - 1 YPOCETIHW - ODA -LANIGIROLABORATOIRE - VERT - 4 EIPOCUELB - ERIOTAROBAL- 3 EIPOCESOR - FITROPS - 2 EIPOCNOTIFICATION DU SPORTIF - ORANGE- 1 EIPOCCNALB - DAO - LANIGIRO

3. INFORMATION FOR ANALYSIS • INFORMATIONS CONCERNANT L’ANALYSE

AAAA / YYYYMMJJ / DD

DATE OF TESTDATE DU CONTRÔLE

DECLARATION OF MEDICATION USE AND BLOOD TRANSFUSIONS: LIST ANY PRESCRIPTION / NON-PRESCRIPTION MEDICATIONS OR SUPPLEMENTS, FOR E.G. BETA-2 AGONISTS AND GLUCOCORTICOSTEROIDS, TAKEN OVER THE PAST 7 DAYS (INCLUDE DOSAGE WHERE POSSIBLE) AND ANY TRANSFUSIONS RECEIVED OVER THE LAST SIX MONTHS.DECLARATION D’USAGE DE MÉDICAMENTS ET DE TRANSFUSIONS SANGUINES: INDIQUER LES MÉDICAMENTS PRESCRITS / NON PRESCRITS OU LES COMPLÉMENTS ALIMENTAIRES, Y COMPRIS PAR EXEMPLE, LES BÉTA-2 AGONISTES ET LES GLUCOCORTICOÏDES, PRIS AU COURS DES 7 DERNIERS JOURS (INDIQUER LA DOSE SI POSSIBLE)

M F

VOL. (ml)

GENDERSEXE

SPECIFIC GRAVITYDENSITÉ

1 0TIME SEALED • SCELLE A (HEURE) URINE SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON D’URINE

A/BURINE

VOL. (ml)SPECIFIC GRAVITY

DENSITÉ 1 0

TIME SEALED • SCELLE A (HEURE)

A/B

TEST MISSION CODE • CODE DE MISSION DE CONTRÔLE

PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml) PARTIAL SAMPLE NUMBERNUMÉRO D’ÉCHANTILLON PARTIEL

TIME SEALEDSCELLÉ À (HEURE)

ATHLETE / DCO INITIALSINITIALES DU SPORTIF / ACD

VOL. (ml)

PARTIAL SAMPLE/ÉCHANTILLON

PARTIEL

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONAL SAMPLE CODE NUMBER • NUMÉRO DE CODE D’ÉCHANTILLON ADDITIONNEL

(ADDITIONAL SAMPLE • ÉCHANTILLON ADDITIONNEL)

CONSENT FOR RESEARCH (OPTIONAL) • CONSENTEMENT POUR LA RECHERCHE (OPTIONEL)IN ORDER TO HELP COMBAT DOPING IN SPORT, BY SIGNING BELOW I AGREE THAT MY SAMPLE MAY BE USED FOR ANTI-DOPING RESEARCH PURPOSES. WHEN ALL ANALYSES HAVE BEEN COMPLETED, AND MY SAMPLE WOULDOTHERWISE BE DISCARDED, IT MAY THEN BE USED BY ANY WADA-ACCREDITED LABORATORY FOR ANTI-DOPING RESEARCH OF ANY TYPE, PROVIDED THAT IT CAN NO LONGER BE IDENTIFIED AS MY SAMPLE. AFIN DE CONTRIBUER À LA LUTTE CONTRE LE DOPAGE DANS LE SPORT, J’ACCEPTE, EN SIGNANT CI-DESSOUS, QUE MON ÉCHANTILLON PUISSE ÊTRE UTILISÉ À DES FINS DE RECHERCHE ANTIDOPAGE. QUAND TOUTES LESANALYSES AURONT ÉTÉ EFFECTUÉES, ET ALORS QUE MON ÉCHANTILLON DEVRAIT NORMALEMENT ÊTRE DÉTRUIT, IL POURRA ALORS ÊTRE UTILISÉ PAR UN LABORATOIRE ACCRÉDITÉ PAR L’AMA À DES FINS DE RECHERCHEANTIDOPAGE DE TOUT TYPE, ÉTANT ENTENDU QU’IL NE POURRA PLUS ÊTRE IDENTIFIÉ COMME MON ÉCHANTILLON. SIGNATURE ____________________________________________________________

I ACCEPTJ’ACCEPTE

I REFUSEJE REFUSE

OUT OF COMPETITIONHORS COMPÉTITION

ARRIVAL TIME AT DOPING CONTROL STATIONHEURE D’ARRIVÉE À LA STATION DE CONTRÔLE DU DOPAGE

IN COMPETITIONEN COMPÉTITION

TIME • HEUREBLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/BBLOOD/SANG•

N/A

SAMPLE 1 • ÉCHANTILLON 1

N/A

SAMPLE 2 • ÉCHANTILLON 2

TIME • HEURE

N/A

BLOOD SAMPLE CODE NUMBER NUMÉRO DE CODE D’ÉCHANTILLON DE SANG

A/B•

AINSI QUE TOUTE TRANSFUSION REÇUE AU COURS DES 6 DERNIERS MOIS.

TYPE OF TEST REQUIREDYTICYRTNUOCETADSIUQER ELÔRTNOC ED EPYTELLIV SYAP

GIVEN NAME FAMILY NAMEMONÉRP NOM DE FAMILLE

TROPS YTILANOITANNATIONALITÉ DISCIPLINE

ADDRESS ADRESSE

DOPING CONTROL FORMFORMULAIRE DE CONTRÔLE DU DOPAGE

1. ATHLETE INFORMATION • INFORMATION CONCERNANT LE SPORTIF

2. NOTIFICATION • NOTIFICATION

AAAA / YYYYMMJJ / DD

4. CONFIRMATION OF PROCEDURE FOR URINE AND/ 0R BLOOD TESTING • CONFIRMATION DE LA PROCÉDURE POUR LE CONTRÔLE D’URINE ET/OU DE SANGCOMMENTS: ANY COMMENTS SHOULD BE NOTED HERE. IF NECESSARY CONTINUE ON A SUPPLEMENTARY REPORT FORM.COMMENTAIRES: TOUS LES COMMENTAIRES DEVRAIENT ÊTRE INSCRITS ICI. AU BESOIN, UTILISER LE FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE.

I DECLARE THAT THE INFORMATION I HAVE GIVEN ON THIS DOCUMENT IS CORRECT. I DECLARE THAT, SUBJECT TO COMMENTS MADE IN SECTION 4, SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES FOR SAMPLE COLLECTION. I ACCEPT THAT ALL INFORMATIONRELATED TO DOPING CONTROL, INCLUDING BUT NOT LIMITED TO LABORATORY RESULTS AND POSSIBLE SANCTIONS, SHALL BE SHARED WITH RELEVANT BODIES IN ACCORDANCE WITH THE WORLD ANTI-DOPING CODE.I HAVE READ AND UNDERSTOOD THE TEXT OVERLEAF, AND I CONSENT TO THE PROCESSING OF MY PERSONAL DATA THROUGH ADAMS.

JE DÉCLARE QUE L'INFORMATION FOURNIE DANS CE DOCUMENT EST EXACTE. JE DÉCLARE, EN TENANT COMPTE DES COMMENTAIRES INSCRITS DANS LA SECTION 4, QUE LE PRÉLÈVEMENT D'ÉCHANTILLONS S’EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCEDURES APPLICABLES. J'ACCEPTE QUETOUTES LES INFORMATIONS RELATIVES AU CONTRÔLE DU DOPAGE, INCLUANT MAIS NON LIMITÉES AUX RÉSULTATS DE LABORATOIRE ET AUX SANCTIONS POSSIBLES, PUISSENT ÊTRE PARTAGÉES AVEC LES ORGANISATIONS CORRESPONDANTES SELON LE CODE MONDIAL ANTIDOPAGE.J'AI LU ET COMPRIS LE TEXTE AU VERSO ET JE CONSENS AU TRAITEMENT DE MES DONNEES PERSONNELLES PAR ADAMS.

TEST AUTHORISED BY CONTRÔLE AUTORISÉ PAR

SAMPLE COLLECTION AUTHORITY AUTORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS

RESULTS MANAGEMENT AUTHORITY AUTORITÉ DE GESTION DES RESULTANTS

DATE OF BIRTH DATE DE NAISSANCE

ATHLETE ID PROVIDED?PIÈCE D’IDENTITÉ DU SPORTIF

YES • OUI NO • NON

DOCUMENT NUMBERNUMÉRO DE DOCUMENT

NUMBER/STREET • NUMÉRO/RUE CITY/TOWN • ETATSELLIV • PROVINCE

COUNTRY • PAYS CONTACT TEL (INCL. COUNTRY CODE)• TÉL CONTACT (INCL. CODE PAYS) E-MAIL • COURRIEL

DOCUMENT TYPETYPE DE DOCUMENT

( )

URINE BLOOD • SANG

TIMEHEURE

ATHLETE’S SIGNATURE • SIGNATURE DU SPORTIF

I HEREBY ACKNOWLEDGE THAT I HAVE RECEIVED AND READ THIS NOTICE, INCLUDING THE ATHLETE RIGHTS AND RESPONSIBILITIESTEXT ON THE OVERLEAF OF COPY 4, AND I CONSENT TO PROVIDE SAMPLE(S) AS REQUESTED (I UNDERSTAND THAT FAILURE ORREFUSAL TO PROVIDE A SAMPLE MAY CONSTITUTE AN ANTI-DOPING RULE VIOLATION).JE RECONNAIS AVOIR REÇU LU CET AVIS, Y COMPRIS LES DROITS ET LES RESPONSABILITÉS DU SPORTIF FIGURANT AU VERSO DE LA COPIE 4, ET JE CONSENS À FOURNIR L’(LES) ÉCHANTILLON(S) TEL(S)QUE REQUIS (JE COMPRENDS QUE LE REFUS OU LE FAIT DE MESOUSTRAIRE À FOURNIR UN ÉCHANTILLON CONSTITUE UNE VIOLATION DES RÈGLES ANTIDOPAGE).

TIME OF COMPLETION • COMPLÉTÉ À (HEURE)

DATE

DCO/CHAPERONE NAMENOM DE L’ACD/ESCORTE

DCO/CHAPERONE SIGNATURESIGNATURE DE

L’ACD/ESCORTE

ATHLETE’S SIGNATURESIGNATURE DU SPORTIF

SUPPLEMENTARY REPORT FORM? FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE?

N/A NUMBER • NUMÉRO

ADDITIONALSAMPLE

ÉCHANTILLONADDITIONNEL

AAAA / YYYYMMJJ / DD

AAAA / YYYYMMJJ / DD

N / A

N / A

N / A

COACH’S NAME • NOM DE L’ENTRAÎNEUR DOCTOR’S NAME • NOM DU MÉDECIN

I CERTIFY THAT SAMPLE COLLECTION WAS CONDUCTED IN ACCORDANCE WITH THE RELEVANT PROCEDURES• JE CERTIFIE PAR LA PRÉSENTE QUE LE PRÉLÈVEMENT D'ÉCHANTILLON S'EST DÉROULÉ EN CONFORMITÉ AVEC LES PROCÉDURES APPLICABLESURINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE URINE SAMPLE WITNESS • TÉMOIN D’ÉCHANTILLON D’URINE

NAME • NOM ERUTANGISMON • EMAN ERUTANGIS

BLOOD COLLECTION OFFICER • AGENT DE PRÉLÈVEMENT SANGUIN

NAME • NOM SIGNATURE

ATHLETE REPRESENTATIVE • REPRÉSENTANT DU SPORTIF

NAME • NOM ERUTANGISNOITCNOF • NOITISOP

DOPING CONTROL OFFICER • AGENT DE CONTRÔLE DU DOPAGE

NAME • NOM SIGNATURE

FRON

T OF

COP

Y 4

T12402-WADA-Doping Control form:Layout 1 2/10/10 10:03 AM Page 9

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7.3 Completing the Chain of Custody Form © WADA – Version 3.0 – May 2011

7.3 Completing the Chain of Custody Form

Purpose

The purpose of this instruction is to ensure the Chain of Custody Form, developed by WADA, is completed appropriately. These instructions are to be used in conjunction with Version 3 (12-2010) of the Chain of Custody Form.

General Comments

The DCO will be responsible for completing a Chain of Custody Form. The 24 hour clock should be used for all times e.g. eight thirty in the morning (8:30 am)

is 08:30, and eight thirty in the evening (8:30 pm) is 20:30. The date format is DD/MM/YYYY therefore the 7th

Write clearly in block capitals and press hard to ensure all copies are legible.

September 2009 is written 07/09/2009.

The DCO will draw a clear line through any part of the form which is not applicable, including unused boxes for sample code numbers.

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7.3 Completing the Chain of Custody Form © WADA – Version 3.0 – May 2011

Summary Checklist Top Right Section of Form Test Authorised By: Insert the name of the organization which requested/authorised the

test (e.g. WADA, IAAF, ADO, etc.). Sample Collection Agency: Insert the name of the organization which has certified you,

the DCO, to conduct sample collection. Results Management Authority: Complete with the name of the organization under whose

anti-doping rules possible violations would be managed (e.g. International Federation, National Anti-Doping Organization)

Section 1. Sample Collection Session

All portions of this section must be completed. The DCO should print his / her name. Indicate whether the test was in-competition or out-of-competition. Indicate the test mission code as provided by the ADO, if applicable. Indicate the location of the mission. Indicate the number of samples (urine and / or blood) included in the shipment. Please

note that a maximum of 10 samples can be recorded on one Chain of Custody Form. If more than 10 samples have been collected, then additional Chain of Custody Forms will be required.

Record the Sport and Sport Federation in relation to the mission. Indicate the date of the sample collection session.

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7.3 Completing the Chain of Custody Form © WADA – Version 3.0 – May 2011

Section 2. Sample Code Numbers and Analytical Information Clearly write the sample code number for all of the samples included in the shipment to

the Laboratory. Where appropriate, record any specific sample analysis required for individual samples.

This section should only be completed if applicable and if directed to do so by the ADO.

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7.3 Completing the Chain of Custody Form © WADA – Version 3.0 – May 2011

Section 3. Chain of Custody, Transportation and Storage

Indicate every change in custody of the samples.

NOTE: The actual transfer of the samples to the laboratory, courier or other should not be included as this information will be included in Section 4. DCO Transfer to Laboratory, Courier or Other of the Form.

Upon completion of the sample collection session, and once the samples have been

prepared for transportation, the DCO responsible for the transportation and storage of the samples should print their name, signature and position.

The date and time the samples were solely in the possession of the DCO should be recorded, and if appropriate the seal number (if used on the transportation device).

The DCO should detail any pertinent information in relation to the location, transportation and storage of the samples whilst they are in his / her possession.

If the samples are moved into the custody of another DCO, the name, signature and position of this person shall be recorded on a new line as well as the date and time of this transfer of custody of the samples. This person then retains the Chain of Custody Form and details any pertinent information in relation to the location, transportation and storage of the samples.

If directed to do so by the ADO

, the DCO may record a new time and date etc for every change in location and/or when a seal number is being applied (for example if a seal is broken by the DCO in order to check the integrity of the samples). In such cases, the DCO should record their own name, signature and position again as the person who has received the samples

NOTE: The reason(s) for sealing/opening the courier bag should be outlined on the Doping Control Officer Report Form.

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7.3 Completing the Chain of Custody Form © WADA – Version 3.0 – May 2011

Section 4. DCO Transfer to Laboratory, Courier or Other

Indicate when and to whom the samples were transferred for the final time. This will usually be the laboratory that will perform the analysis or the courier company who will deliver the samples to the laboratory.

The DCO should record their name and the date and time the samples are being transferred.

The person to whom you are handing over the samples should print their name and sign the Form.

If handed to a courier company, the name of the courier company, the waybill number, the name of the individual courier and the courier’s signature should be recorded.

The last copy (yellow) of the Form will accompany the samples and the original (white) and copy 1 (green) will be returned to the ADO.

NOTE: One Chain of Custody Form is required for every courier transport bag of samples sent to a laboratory. In the following situations, the samples can be transported in the same courier transport bag - If testing multiple sports in one day, however a separate Chain of Custody Form is

required for each sport; If testing one sport over multiple days (i.e. an event), however a separate Chain of

Custody Form is required for each day of testing; If testing for multiple Anti-Doping Organizations (ADOs), however a separate Chain of

Custody Form is required for each ADO.

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CHAIN OF CUSTODY FORMCHAÎNE DE POSSESSION

TEST AUTHORISED BYCONTRÔLE AUTORISÉ PAR

SAMPLE COLLECTION AUTHORITYAUTORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS

RESULTS MANAGEMENT AUTHORITYAUTORITÉ DE GESTION DES RESULTANTS

DATE

1. SAMPLE COLLECTION SESSION • SÉANCE DE PRÉLÈVEMENT D’ÉCHANTILLON

DD / JJ MM YYYY / AAAA

2. SAMPLE CODE NUMBERS AND ANALYTICAL INFORMATION • NUMÉROS DE CODE D’ÉCHANTILLON ET INFORMATIONS SUR L’ANALYSE

3.CHAIN OF CUSTODY, TRANSPORTATION AND STORAGE • CHAÎNE DE POSSESSION, TRANSPORT ET CONSERVATION

4. DCO TRANSFER TO LABORATORY OR COURIER • TRANSFERT PAR L’ACD : LABORATOIRE OU MESSAGER

IF TRANSFERRED TO LABORATORY / SI TRANSFÉRÉ AU LABORATOIRE

IF TRANSFERRED TO COURIER / SI TRANSFERT AU MESSAGER

A/B

A/B

A/B

A/B

A/B

A/B

A/B

A/B

A/B

A/B

NAMENOM

DATEDD / JJ MM YYYY / AAAA

DROP-OFF TIMEHEURE DE LIVRAISON

DCO NAMENOM DE

L’ACD

CITY / VILLE STATE / PROVINCE COUNTRY / PAYSURINE BLOOD / SANG

SPORTDISCIPLINE

SPORT FEDERATIONFÉDÉRATION SPORTIVE

DCO NAMENOM DE L’ACD

LAB REP. NAMENOM DU

REPRÉSENTANT DU LABORATOIRE

LAB REP. POSITIONTITRE DU

REPRÉSENTANT DU LABORATOIRE

LAB REP. SIGNATURESIGNATURE DU

REPRÉSENTANT DULABORATOIRE

COMPANY NAMENOM DE

L’ENTREPRISE

WAYBILL NUMBERNUMÉRO DE LA

FEUILLE DE ROUTELOCATION

LIEU

COURIER SIGNATURESIGNATURE DU MESSAGER

COURIER NAMENOM DU

MESSAGER

ORIGINAL - ADO - WHITE COPY 1 - SAMPLE COLLECTION AUTHORITY - GREEN COPY 2 - LABORATORY - YELLOW VERSION 3: 12-2010 (WADA/AMA)ORIGINAL - OAD - BLANC COPIE 1 - AUTHORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS - VERT COPIE 2 - LABORATOIRE - JAUNE

TEST LOCATIONLIEU DU

CONTRÔLE

NUMBER OF SAMPLESNOMBRE

D’ÉCHANTILLONS

OUT OF COMPETITIONHORS COMPÉTITION

IN COMPETITIONEN COMPÉTITION

TEST MISSION CODECODE DE MISSION

DE CONTRÔLE

SEAL NUMBER (IF APPLICABLE)NUMÉRO DU SCEAU (AU BESOIN)

SAMPLE CODE NUMBERSNUMÉROS DES CODES D’ÉCHANTILLONS

SPECIFIC SAMPLE ANALYSIS (IF APPLICABLE)ANALYSE PARTICULIÈRE D’ÉCHANTILLON (AU BESOIN)

SAMPLE CODE NUMBERSNUMÉROS DES CODES D’ÉCHANTILLONS

SPECIFIC SAMPLE ANALYSIS (IF APPLICABLE)ANALYSE PARTICULIÈRE D’ÉCHANTILLON (AU BESOIN)

SIGNATUREPOSITION/ROLE

POSTE/TITRE/RÔLE

DETAILS OF LOCATION/TRANSPORTATION/STORAGE

DÉTAILS DE LIEU/TRANSPORT/CONSERVATION

RECEIVED BYREÇU PAR

DATEDD / JJ MM YYYY / AAAA

TIMEHEURE

NAMENOM

SEAL NUMBER (IF APPLICABLE)NUMÉRO DU SCEAU (AU BESOIN)

SIGNATUREPOSITION/ROLE

POSTE/TITRE/RÔLE

DETAILS OF LOCATION/TRANSPORTATION/STORAGE

DÉTAILS DE LIEU/TRANSPORT/CONSERVATION

RECEIVED BYREÇU PAR

DATEDD / JJ MM YYYY / AAAA

TIMEHEURE

NAMENOM

SEAL NUMBER (IF APPLICABLE)NUMÉRO DU SCEAU (AU BESOIN)

SIGNATUREPOSITION/ROLE

POSTE/TITRE/RÔLE

DETAILS OF LOCATION/TRANSPORTATION/STORAGE

DÉTAILS DE LIEU/TRANSPORT/CONSERVATION

RECEIVED BYREÇU PAR

DATEDD / JJ MM YYYY / AAAA

TIMEHEURE

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7.5 Completing the Doping Control Officer Report Form © WADA – Version 3.0 – May 2011

7.5 Completing the Doping Control Officer Report Form

Purpose

The purpose of this instruction is to ensure the Doping Control Officer Report Form, developed by WADA, is completed appropriately.

General Comments These instructions are to be used in conjunction with Version 3 (9-2010) of the Doping Control Officer Report Form.

The DCO will be responsible for completing a Doping Control Officer Report Form. The DCO Report Form should be completed for each mission and all copies must be

returned to the ADO. The date format is DD/MM/YYYY therefore the 7th

Write clearly in block capitals and press hard to ensure all copies are legible. September 2009 is written 07/09/2009.

If you have insufficient space on any part of the Form, you may use Section 5. General Comments and Suggestions or a Supplementary Report Form.

Any deviation from the standard procedure must be noted in Section 5. General Comments and Suggestions.

A clear line will be drawn through any part of the Form which is not applicable.

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7.5 Completing the Doping Control Officer Report Form © WADA – Version 3.0 – May 2011

Summary Checklist Top Right Section of Form Test Authorised By: Complete with the name of the organization which

requested/authorised the test (e.g. WADA, IAAF, ADO etc) Sample Collection Agency: Complete with the name of the organization which has

certified him/her to conduct sample collection (e.g. ADO) Results Management Authority: Complete with the name of the organization under whose

anti-doping rules possible violations would be managed (e.g. International Federation, National Anti-Doping Organization)

Section 1. Description of Mission

All portions of this section will be completed Record the Test Mission Code (if applicable) Ensure you mark the event as in-competition or out-of-competition and record the date of

the mission For an in-competition sample collection mission state the name of the event. For an out-

of-competition sample collection mission state the name of the session / training camp and / or the location where the sample collection occurred

Record the type of venue the mission took place at (e.g. athlete’s home address, training venue or competition). If Other, specify the type of venue in the box provided.

Provide the name of the Athlete’s sport federation Insert the number of blood and/or urine tests which were completed

Note: this would be the number of Athletes tested

Section 2. Personnel

Indicate the name and position of all sample collection personnel present, including other

DCOs, Chaperones, interpreters, etc. Include the name and position of sport federation representative(s) present during the

sample collection session

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7.5 Completing the Doping Control Officer Report Form © WADA – Version 3.0 – May 2011

Section 3. Athlete Selection

Confirm whether or not tests were carried out in accordance with the sample collection/mission order. If they were not, include an explanation in Section 5. General Comments and Suggestions (e.g. not all Athletes were present, alternate Athletes were selected, etc.)

Confirm whether or not Athletes selected were in accordance with the sample collection/mission order. If they were not, include an explanation in Section 5. General Comments and Suggestions (e.g. the number of Athletes present does not meet the number of tests requested, could not select Athletes at random, etc.)

Section 4. Sample Collection

All questions should be answered in this section, and further details should be recorded in

Section 5. General Comments and Suggestions Indicate whether the facilities were adequate to conduct the testing.

Indicate whether the tests were no-advance notice If the Athlete requested a delay in reporting to the doping control station, the length of

time of the delay and the reasons for the delay should be recorded The DCO will show the Athlete the relevant authorization documentation (i.e. authorization

letter). If authorization documentation was not shown, the DCO will need to provide an explanation

If the Athletes were not chaperoned at all times from notification to sample provision, an explanation should be provided.

If there were any issues with the sample collection equipment, the details should be outlined.

The details of any modifications to the procedures should be provided. If there were any deviations from the International Standards regarding sample collection

and / or sample storage, the reasons should be outlined.

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7.5 Completing the Doping Control Officer Report Form © WADA – Version 3.0 – May 2011

Section 5. General Comments and Suggestions

Document any other details regarding the sample collection session that have not yet

been included in the Form Use this section if you require more space for the one of the other sections on the Form If there is insufficient space in this section then a Supplementary Report Form should be

used. If a Supplementary Report Form has been used in relation to the DCO Report Form, the

corresponding Supplementary Report Form number should be recorded.

Section 6. Confirmation

Complete the date and the test mission code (if provided) Print and sign your name as the DCO

Paperwork All copies of the DCO Report Form should be sent back to the Sample Collection Authority. The ‘For Internal Use Only’

space has been provided to record the ADO’s review of the DCO Report Form.

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WERE ALL TESTS ON THE MISSION ORDER COMPLETED?LES CONTRÔLES DÉCRITS SUR L’ORDRE DE MISSION ONT-ILS TOUS ÉTÉ EFFECTUÉS?

WERE ATHLETES SELECTED IN ACCORDANCE WITH THE MISSION ORDER?LES SPORTIFS ONT-ILS ÉTÉ SÉLECTIONNÉS CONFORMÉMENT À L’ORDRE DE MISSION?

1. DESCRIPTION OF MISSION • DESCRIPTION DE LA MISSION

2. PERSONNEL

3. ATHLETE SELECTION • SÉLECTION DU SPORTIF

SAMPLE COLLECTION PERSONNEL / PERSONNEL DE PRÉLÈVEMENT DES ÉCHANTILLONS

________________________________________ ____________________________________ ________________________________________ ____________________________________

________________________________________ ____________________________________ ________________________________________ ____________________________________

SPORT FEDERATION REPRESENTATIVE / REPRÉSENTANT DE LA FÉDÉRATION SPORTIVE

________________________________________ ____________________________________ ________________________________________ ____________________________________

4.SAMPLE COLLECTION • PRÉLÈVEMENT D’ÉCHANTILLON

5. GENERAL COMMENTS AND SUGGESTIONS • COMMENTAIRES GÉNÉRAUX ET SUGGESTIONS(COMPLETE SEPARATE SUPPLEMENTARY REPORT FORM IF SPACE IS INSUFFICIENT) • (AU BESOIN, VEUILLEZ REMPLIR UN AUTRE FORMULAIRE DE RAPPORT SUPPLÉMENTAIRE)

6. CONFIRMATION

DOPING CONTROL OFFICER REPORT FORMFORMULAIRE DE L’AGENT DE CONTRÔLE DU DOPAGE

DD / JJ MM YYYY / AAAA

URINE BLOOD • SANG

DD / JJ MM YYYY / AAAA

NUMBER / NUMÉRO

SUPPLEMENTARYREPORT FORM?

FORMULAIRE DE RAPPORTSUPPLÉMENTAIRE?

N/AS/O

DATE

FOR INTERNAL USE ONLYÀ USAGE INTERNE SEULEMENT

ORIGINAL - ADO - WHITEORIGINAL - OAD - BLANC

COPY 1 - SAMPLE COLLECTION AUTHORITY - GREENCOPIE 1 - AUTHORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS - VERT

VERSION 3: 09-2010 (WADA/AMA)

TEST AUTHORISED BYCONTRÔLE AUTORISÉ PAR

SAMPLE COLLECTION AUTHORITYAUTORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS

RESULTS MANAGEMENT AUTHORITYAUTORITÉ DE GESTION DES RESULTANTS

OUT OF COMPETITIONHORS COMPÉTITION

COMPETITION VENUELIEU DE LA COMPÉTITION

TRAINING VENUELIEU DE L’ENTRAÎNEMENT

ATHLETE’S HOMEDOMICILE DU SPORTIF

OTHER (SPECIFY)AUTRE (VEUILLEZ

PRÉCISER)

DATE OF SESSIONDATE DE LA SÉANCE

NO. OF SAMPLES COLLECTEDNOMBRE D’ÉCHANTILLONS PRÉLEVÉS

IN COMPETITIONEN COMPÉTITION

EVENT / LOCATIONÉVÉNEMENT / LIEU

SPORT FEDERATIONFÉDÉRATION SPORTIVE

NAMENOM

NAMENOM

POSITIONTITRE

POSITIONTITRE

NAMENOM

POSITIONTITRE

NAMENOM

NAMENOM

POSITIONTITRE

POSITIONTITRE

NAMENOM

POSITIONTITRE

YES / OUI

NO / NON (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

YES / OUI

NO / NON (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

WERE THE FACILITIES ADEQUATE?LES INSTALLATIONS ÉTAIENT-ELLES ADÉQUATES?

WERE ALL THE TESTS CONDUCTED AT NO ADVANCE NOTICE?LES CONTRÔLES ONT-ILS TOUS ÉTÉ EFFECTUÉS SANS PRÉAVIS?

DID ANY ATHLETE REQUIRE A DELAY IN REPORTING TO THE DOPING CONTROL STATION?AVEZ-VOUS NOTÉ CHEZ UN SPORTIF UN DÉLAI POUR SE PRÉSENTER AU POSTE DE CONTRÔLE DU DOPAGE?

WERE THE ATHLETES SHOWN THE LETTER(S) OF AUTHORITY?LETTRE(S) D’AUTORISATION ONT-ELLES ÉTÉ PRÉSENTÉES AUX SPORTIFS?

WERE THE ATHLETES CHAPERONED AT ALL TIMES FROM NOTIFICATION UNTIL SAMPLE PROVISION?LES SPORTIFS ONT-ILS ÉTÉ ESCORTÉS EN PERMANENCE, DEPUIS LA NOTIFICATION JUSQU’À LA FOURNITURE DE L’ÉCHANTILLON?

WERE ANY ISSUES ENCOUNTERED WITH THE SAMPLE COLLECTION EQUIPMENT?AVEZ-VOUS EU DES PROBLÈME AVEC L’ÉQUIPEMENT DE PRÉLÈVEMENT DES ÉCHANTILLONS?

WERE ANY MODIFICATIONS TO PROCEDURES PUT IN PLACE TO ACCOUNT FOR ATHLETES WITH A DISABILITY AND/OR MINORS?LA PROCÉDURE A-T-ELLE ÉTÉ MODIFIÉE AFIN DE TENIR COMPTE DES BESOINS DES SPORTIFS HANDICAPÉS OU DES MINEURS?

WERE ALL SAMPLES COLLECTED IN ACCORDANCE WITH THE INTERNATIONAL STANDARD FOR TESTING (IST)?LES ÉCHANTILLONS ONT-ILS TOUS ÉTÉ PRÉLEVÉS EN CONFORMITÉ AVEC LES STANDARDS INTERNATIONAUX DE CONTRÔLE (SIC)?

WERE ALL SAMPLES (INC. PARTIAL SAMPLES), STORED IN ACCORDANCE WITH THE INTERNATIONAL STANDARD FOR TESTING (IST)?LES ÉCHANTILLONS (Y COMPRIS LES ÉCHANTILLONS PARTIELS) ONT-ILS TOUS ÉTÉ CONSERVÉS EN CONFORMITÉ AVEC LES STANDARDS INTERNATIONAUX DE CONTRÔLE (SIC)?

YES / OUI

NO / NON (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

YES / OUI

NO / NON (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

YES / OUI (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

NO / NON

YES / OUI

NO / NON (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

YES / OUI

NO / NON (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

YES / OUI (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

NO / NON

YES / OUI (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

NO / NON

YES / OUI

NO / NON (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

YES / OUI

NO / NON (PROVIDE FURTHER DETAILS IN SECTION 5 / FOURNISSEZ PLUS DE DÉTAILS DANS LA SECTION 5)

DCO NAMENOM DE L’ACD

DCO SIGNATURESIGNATURE DE L’ACD

CHECKED BY:VÉRIFIÉ PAR:

FOLLOW-UP:SUIVI:DATE:

TEST MISSION CODECODE DE MISSION DE CONTRÔLE

T16477-WADA Officer Report form_2:Doping Control 9/1/10 1:12 PM Page 1

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7.7 Completing the Supplementary Report Form © WADA – DCO Manual - Version 3.0 – May 2011

7.7 Completing the Supplementary Report Form

Purpose

The purpose of this instruction is to ensure the Supplementary Report Form, developed by WADA, is completed appropriately.

General Comments

The Supplementary Report Form is normally completed by the DCO, the Athlete or the

Athlete Representative. Others may complete the Supplementary Report Form if necessary (e.g. Chaperone).

The Form must be signed by the DCO, as well as the person completing the Form. Each Supplementary Report Form has a unique, pre-printed number. This number must be

recorded on the Doping Control Form or on the Doping Control Officer Report Form so that the forms can be linked.

Write clearly in block capitals and press hard to ensure all copies are legible.

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7.7 Completing the Supplementary Report Form © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist Section 1. Completed by: Complete the box indicating who completed the Supplementary

Report Form.

Section 2. Purpose of Report: Complete the box indicating the purpose of the

Supplementary Report Form.

Section 3. Report: Complete detailing the content of the report, including sample code

numbers, names and full details of the doping control session as relevant.

Section 4. Confirmation of Procedure: The form must be signed by the DCO, as well as by

the person completing the form.

The person completing the Form will receive the final (pink) copy of the Supplementary

Report Form.

The ADO will receive the original (white) and copy 1 (green) of the Supplementary Report Form.

NOTE: If the Supplementary Report Form is being used to record medications declared by the Athlete, then the pink copy will be given to the Athlete; the green copy will be sent to the laboratory; and the white copy (original) will be sent to the ADO. If a Supplementary Report Form is used to record medications/supplements declared by an Athlete, do not

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7.7 Completing the Supplementary Report Form © WADA – DCO Manual - Version 3.0 – May 2011

record the Athlete’s name on the Form. Only record the sample code number related to those medications.

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DOPING CONTROL OFFICER ATHLETE ATHLETE REPRESENTATIVE OTHER (specify)AGENT DE CONTRÔLE DU DOPAGE SPORTIF REPRÉSENTANT DU SPORTIF AUTRE (spécifier)

SUPPLEMENTARY REPORT FORMFORMULAIRE DE RAPPORT SUPPLÉMENTAIRE

3. SUPPLEMENTARY REPORT • RAPPORT SUPPLÉMENTAIREPROVIDE REASON FOR REPORT, RELEVANT SAMPLE CODE NUMBERS, NAMES AND FULL DETAILS • FOURNIR LA RAISON DU RAPPORT, NUMÉROS DE CODE D’ÉCHANTILLONS CORRESPONDANTS, NOMS ET DÉTAILS COMPLETS

1. COMPLETED BY • COMPLÉTÉ PAR

NAMENOM SIGNATURE

DCO NAME DATE NOM DE L’ACD SIGNATURE

ORIGINAL - ADO - WHITE COPY 1- AUTHORISED COLLECTION AGENCY - GREEN COPY 2 - PERSON COMPLETING FORM - PINK VERSION 2: 04-2004 (WADA/AMA)ORIGINAL - OAD - BLANC COPIE 1 - AGENCE DE PRÉLÈVEMENT AUTORISÉE - VERT COPIE 2 - PERSONNE AYANT COMPLÉTÉ LE FORMULAIRE - ROSE

ATHLETE FAILURE TO COMPLY DECLARATION OF MEDICATION (DOPING CONTROL FORM) COMMENTS (DOPING CONTROL FORM)DÉFAUT DE SE CONFORMER DÉCLARATION DE MÉDICATION (FORMULAIRE DE CONTRÔLE DU DOPAGE) COMMENTAIRES (FORMULAIRE DE CONTRÔLE DU DOPAGE)

SUPPLEMENTARY DCO REPORT OTHER (specify)RAPPORT SUPPLÉMENTAIRE DE L’ACD AUTRE (spécifier)

2. PURPOSE OF REPORT • OBJET DU RAPPORT

4. CONFIRMATION OF PROCEDURE • CONFIRMATION DE LA PROCÉDURE

SRF NUMBER • NUMÉRO FRS

DD / JJ MM YYYY / AAAA

Supplementary Report Form_Ext-Orgs.qxd 14/04/2004 5:53 PM Page 1

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7.9 Completing the Unsuccessful Attempt Report Form © WADA – Version 3.0 – May 2011

7.9 Completing the Unsuccessful Attempt Report Form

Purpose

The purpose of this instruction is to ensure the Unsuccessful Attempt Report Form, developed by WADA, is completed appropriately.

General Comments

The Unsuccessful Attempt Report Form is completed by the DCO for any mission where an

unsuccessful attempt has been made to locate the Athlete during their designated 60-minute whereabouts slot (as defined in the Athlete’s whereabouts filing).

This form may be used in the assertion of a Whereabouts Failure and/or an Anti-Doping Rule Violation and therefore it is essential that all information recorded is accurate and as detailed as possible.

The Form must be signed by the DCO. Write clearly in block capitals and press hard to ensure all copies are legible. The 24 hour clock must be used for all times e.g. eight thirty in the morning (8:30am) is

08:30, and eight thirty in the evening (8:30pm) is 20:30. If the DCO has insufficient space on any part of the form, he/she may use a

Supplementary Report Form. The Supplementary Report Form reference number should be recorded in Section 3 of this form.

NOTE: Whilst the primary focus of the form is to detail attempts made to locate the Athlete during their designated 60-minute whereabouts slot, this form should also be used to record details of any attempts made to locate the Athlete throughout the course of the mission.

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7.9 Completing the Unsuccessful Attempt Report Form © WADA – Version 3.0 – May 2011

Summary Checklist

Top Right Section of the Form

Test Authorized By: The DCO will insert the name of the organization which

initiated/authorized the test. Sample Collection Agency: The DCO will insert the name of the organization which has

certified him/her to conduct sample collection. Results Management Authority: The DCO will insert the name of the organization under

whose anti-doping rules possible violations would be managed (e.g. the International Federation, National Anti-Doping Organization).

Section 1. Athlete Information

The DCO should record all relevant information regarding the Athlete. This information should be provided on the Mission Order (or testing request from the ADO).

Sport Discipline

is the sport and the discipline of the Athlete. E.g. skiing/freestyle.

Section 2. Mission Information

The DCO should record the Test Mission Code (if applicable) and whether the unsuccessful attempt was made Out-of-Competition or In-Competition.

The DCO should record the date that he/she last checked, or the date that he/she was last updated about, the Athlete’s whereabouts prior to attempting the mission.

It is essential that the DCO provides a copy of the Athlete whereabouts he/she used to attempt the mission, when submitting the completed Unsuccessful Attempt Report Form.

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7.9 Completing the Unsuccessful Attempt Report Form © WADA – Version 3.0 – May 2011

Section 3. Attempt Information

The DCO should first document the details of the location, date and timing of their attempt made during the Athlete’s designated 60-minute whereabouts slot as specified on the Athlete’s whereabouts.

The DCO should document the full and complete address of the location as well as the description of the location.

The DCO should record the date the attempt was made and record the precise arrival and departure times from the location, during which time reasonable attempts, as defined by the ADO, were made to locate the Athlete.

The DCO should initially use Section 3 to record all details relating to their attempts made to locate the Athlete during the Athlete’s designated 60-minte whereabouts slot. The DCO should record all pertinent information regarding the venue, the attempts he/she made (i.e. the frequency and timing of the attempts) as well as full details of any 3rd

Following this, and if applicable, the DCO should also detail any attempts made to locate the Athlete outside of their designated 60-minute whereabouts slot (this includes attempts made prior to and after the attempts during the 60-minute whereabouts slot). The DCO should detail all pertinent information as specified above, as well as recording the location details, date and timings of the attempts made.

party contact. The detail for the latter should include who the DCO had contact with and the details of the discussions had.

If there is insufficient space on the form, the DCO should continue on a Supplementary Report Form. The Supplementary Report Form reference number should be recorded in Section 3 of this form.

If the DCO did not make any attempts to locate the Athlete during their designated 60-minute whereabouts slot, then this form should not be completed. All details instead should be recorded on the Doping Control Officer Report Form

.

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7.9 Completing the Unsuccessful Attempt Report Form © WADA – Version 3.0 – May 2011

Section 4. Confirmation

The DCO should print and sign his/her name. The DCO should record the date he/she completed the Unsuccessful Attempt Report Form.

Distribution of Copies of the Unsuccessful Attempt Report Form All copies of the Unsuccessful Attempt Report Form should be sent back to the Sample

Collection Authority.

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1. ATHLETE INFORMATION • INFORMATION CONCERNANT LE SPORTIF

2. MISSION INFORMATION • INFORMATION CONCERNANT LA MISSION

3. ATTEMPT INFORMATION • INFORMATION CONCERNANT LA TENTATIVE

4. CONFIRMATION

UNSUCCESSFUL ATTEMPT REPORT FORMFORMULAIRE DE TENTATIVE MANQUÉE

DD / JJ MM YYYY / AAAADATE

ORIGINAL - ADO - WHITEORIGINAL - OAD - BLANC

COPY 1 - SAMPLE COLLECTION AUTHORITY - GREENCOPIE 1 - AUTHORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS - VERT

VERSION 1: 07-2010 (WADA/AMA)

TEST AUTHORISED BYCONTRÔLE AUTORISÉ PAR

SAMPLE COLLECTION AUTHORITYAUTORITÉ DE PRÉLÈVEMENT D’ÉCHANTILLONS

RESULTS MANAGEMENT AUTHORITYAUTORITÉ DE GESTION DES RESULTANTS

DCO NAMENOM DE L’ACD

DCO SIGNATURESIGNATURE DE L’ACD

FAMILY NAMENOM DE FAMILLE

DATE ATHLETE WHEREABOUTS LAST CHECKEDDATE DE LA DERNIÈRE VÉRIFICATION DE LA LOCALISATION DU SPORTIF

NATIONALITYNATIONALITÉ

GIVEN NAMEPRÉNOM

SPORTDISCIPLINE

M F

GENDERSEXE

TEST MISSION CODE • CODE DE MISSION DE CONTRÔLE

OUT OF COMPETITIONHORS COMPÉTITION

IN COMPETITIONEN COMPÉTITION

WHEREABOUTS USED • INFORMATIONS SUR LA LOCALISATION UTILISÉE

LOCATIONLIEU

PLEASE PROVIDE A COPY OF THE WHEREABOUTS USED TO ATTEMPT THIS MISSION • VEUILLEZ FOURNIR UNE COPIE DES INFORMATIONS SUR LA LOCALISATION UTILISÉES DANS LE CADRE DE CETTE TENTITIVE

ADDRESSADRESSE

DESCRIPTION OF LOCATIONDESCRIPTION DU LIEU

NUMBER/STREET• NUMÉRO/RUE CITY/TOWN • VILLE STATE • PROVINCE COUNTRY• PAYS

TRAINING VENUESITE D’ENTRAÎNEMENT

ATHLETE’S HOMEDEMICILE DU SPORTIF

OTHER (SPECIFY)AUTRE (PRÉCISEZ)

DD / JJ MM YYYY / AAAA

DATE OF ATTEMPTDATE DE LA TENTATIVE

ARRIVAL TIMEHEURE D’ARRIVÉE

DEPARTURE TIMEHEURE DÉPART

DESCRIPTION OF ATTEMPT: DESCRIBE ALL ATTEMPTS MADE TO LOCATE THE ATHLETE DURING THEIR SPECIFIED 60-MINUTE TIME SLOT. THIS SHOULD INCLUDE BUT NOT BE LIMITED TO A PHYSICAL DESCRIPTION OF THE LOCATION, A SUMMARY OF HOW CONTACT WAS ATTEMPTED(DOORBELL, 3RD PARTY CONTACT, ETC.) AND THE FREQUENCY AND TIMING OF ATTEMPTS MADE. PLEASE ALSO DESCRIBE ANY ATTEMPTS MADE TO LOCATE THE ATHLETE OUTSIDE OF THEIR 60-MINUTE TIME SLOT AT THIS OR ANY OTHER LOCATIONS (IF APPLICABLE). FOR ALLATTEMPTS MADE, PLEASE PROVIDE ANY ADDITIONAL INFORMATION RECEIVED DURING EACH ATTEMPT (FOR E.G. THE ACTUAL LOCATION OF THE ATHLETE).

DESCRIPTION DE LA TENTATIVE: DÉCRIVEZ TOUTES LES TENTATIVES EFFECTUÉES POUR LOCALISER LE SPORTIF DURANT LA PÉRIODE DE 60 MINUTES SPÉCIFIÉE. CES INFORMATIONS DEVRAIENT COMPRENDRE, MAIS SANS S’Y LIMITER, UNE DESCRIPTION PHYSIQUEDES LIEUX, UN RÉSUMÉ DE LA DÉMARCHE ENTOURANT LA TENTATIVE (PAR EX., SONNER À LA PORTE, CONTACT PAR L’INTERMÉDIAIRE D’UN TIERS, ETC.) ET LA FRÉQUENCE ET L’HEURE DES TENTATIVES. VEUILLEZ ÉGALEMENT DÉCRIRE TOUTES LES TENTATIVES FAITESPOUR LOCALISER LE SPORTIF AVANT LA PÉRIODE DE 60 MINUTES SPÉCIFIÉE, À CE LIEU OU AILLEURS (LE CAS ÉCHÉANT). POUR TOUTES LES TENTATIVES EFFECTUÉES, VEUILLEZ FOURNIR TOUTES LES INFORMATIONS ADDITIONNELLES REÇUES DURANT CHAQUETENTATIVE (PAR EX., LA LOCALISATION DU SPORTIF, ETC.)

BY SIGNING BELOW I CONFIRM THAT THE INFORMATION PROVIDED HEREIN IS ACCURATE TO THE BEST OF MY KNOWLEDGE AND THAT THIS INFORMATION MAY BE USED IN ASSERTING AN ANTI-DOPING RULE VIOLATION.JE SOUSSIGNÉ, DÉCLARE QUE LES INFORMATIONS FOURNIES DANS LE PRÉSENT FORMULAIRE SONT EXACTES AU MEILLEUR DE MA CONNAISSANCE ET QUE CES INFORMATIONS POURRAIENT ÊTRE UTILISÉES POUR VALIDER UNE VIOLATION DE RÈGLES ANTIDOPAGE.

DD / JJ MM YYYY / AAAA

T17105-WADA Unsuccessful Attempt Form:Doping Control 7/16/10 10:57 AM Page 1

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8.1 Sending Samples to the Laboratory © WADA – Version 3.0 – May 2011

8.1 Sending Samples to the Laboratory

Purpose

The purpose of this procedure is to describe the process for sending samples that were collected at a sample collection session to the laboratory.

Actions

1. The DCO

should send the samples from a sample collection session to the laboratory as soon as practical. Whenever possible, the samples should be sent to the laboratory on the/each day of testing, once the testing session is concluded.

NOTE: All samples must be sent to a WADA accredited laboratory, unless otherwise approved by the ADO (i.e. for blood samples).

2. When sending samples to the laboratory, the DCO must use one of the ADO-designated

couriers to ship the samples. The ADO will provide direction to the DCO

as to the preferred carrier to use, as well as an alternate carrier, if applicable.

3. The DCO may not leave samples with another individual (e.g., hotel staff, other members of the sample collection personnel, or the site coordinator), and must be the individual who transfers the samples to the courier him/herself.

4. When sending samples collected to the laboratory, the DCO should ensure that the

complete address of the laboratory is on the waybill under To or Consignee.

5. The DCO should ensure that the complete address of the ADO is on the waybill under From or Shipper.

6. Samples may be sent to the laboratory using sealed courier transport bag(s), provided

by the ADO. The DCO must complete the Chain of Custody Form, noting the sample code number of each kit contained in the courier transport bag and the seal number(s) used to secure the courier transport bag. If the DCO has collected more samples than will fit in the courier bag, then he/she must complete multiple Chain of Custody Forms

(one per bag) for the additional samples (See reference 6.6).

7. The DCO must enclose in the bag(s) the laboratory copy of the Doping Control Form for each sample contained in the bag and the laboratory copy of the Chain of Custody Form

. All other sample collection documentation should be returned to the ADO within 48 hours of sending the samples to the laboratory (See reference 8.2).

8. At the time of delivery by the DCO to the courier, the DCO should ensure that the DCO Transfer to Laboratory, Courier or Other Section of the Chain of Custody Form is updated to reflect the time and date of the transfer.

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8.1 Sending Samples to the Laboratory © WADA – Version 3.0 – May 2011

9. The DCO should send the appropriate shipper’s copy of the waybill to ADO along with other completed sample collection documentation.

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8.1 Sending Samples to the Laboratory © WADA – Version 3.0 – May 2011

Summary Checklist

The DCO will send the samples to a WADA accredited laboratory (or as indicated by the ADO) as soon as practical after the sample collection session

The DCO will use an ADO-designated courier to ship the samples The DCO will be the individual to transfer the samples to the courier and may not leave

them with another individual The DCO will complete a waybill, including

o Ensuring that the address of the laboratory is under To or Consignee o Ensuring that the address of the ADO is under From or Shipper

The DCO will complete the Chain of Custody Form, including the sample code number of each kit contained in the courier transport bag and the seal number(s) used to secure the courier transport bag

The DCO will ensure that the following documents are included in the courier transport bag,

o The laboratory copy of the Doping Control Form for each sample contained in the bag

o The green laboratory copy of any Supplementary Report Form used to record additional medications. NOTE: This form must not identify the athlete.

o The laboratory copy of the Chain of Custody Form A separate Chain of Custody Form must be used for each courier transport bag used

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8.2 Returning Paperwork to the ADO © WADA – DCO Manual - Version 3.0 – May 2011

8.2 Returning Paperwork to the ADO

Purpose The purpose of this procedure is to describe the process of returning completed sample collection documentation from in-competition or out-of-competition sample collection sessions to the ADO.

Actions

1. DCOs should ship all appropriate copies of completed sample collection documentation to the ADO within 48 hours

of shipping the samples to the laboratory. This will ensure that these documents will be available to the ADO in time to match them with any results received from the laboratory.

NOTE: DCOs should send, by e-mail or fax, a brief summary of the sample collection session to the ADO prior to shipping the documentation to the ADO. This summary should include the name of Athletes tested, corresponding sample code numbers and the courier waybill tracking number.

2. When shipping the documentation to the ADO, the DCO must use one of the ADO-

designated couriers.

3. When possible, the ADO will provide pre-printed waybills or return labels, and envelopes indicating appropriate shipping and packaging instructions.

4. When shipping sample collection documentation to the ADO, the DCO must place all ADO

copies of all documents in the appropriate envelope, including the following items, if applicable:

• Chaperone Responsibilities Forms • Doping Control Forms (at least 1 per Athlete tested) • Supplementary Report Form(s) • Chain of Custody Form(s) (1 per courier transport bag) • Doping Control Officer Report Form (1 per mission/event) • Waybill used for shipping samples to the laboratory (1 per courier transport bag) • Entry/Exit Log (1 per mission/event) • All documentation involving Athlete names e.g. selection lists, team sheets, out-of-

competition draw lists issued by the ADO

5. The DCO must ensure that the appropriate waybill or pre-printed return label is affixed to the appropriate envelope. NOTE: DCOs represent the first adequacy/accuracy check of testing paperwork prior to the ADO. If any anomalies are identified by the DCO post-event and prior to returning

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8.2 Returning Paperwork to the ADO © WADA – DCO Manual - Version 3.0 – May 2011

paperwork to the ADO then a Supplementary Report Form should be completed detailing the anomalies. The ADO may be contacted for guidance.

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8.2 Returning Paperwork to the ADO © WADA – DCO Manual - Version 3.0 – May 2011

Summary Checklist

The DCO will return all paperwork to the ADO within 48 hours of sending the samples to

the laboratory, including Chaperone Responsibilities Forms Doping Control Forms (at least 1 per Athlete tested) Supplementary Report Form(s) Chain of Custody Form(s) (1 per courier transport bag) Doping Control Officer Report Form (1 per mission/event) Waybill used for shipping samples to the laboratory (1 per courier transport bag) Entry/Exit Log (1 per mission/event) All documentation involving Athlete names e.g. selection lists, team sheets, out-

of-competition draw lists issued by the ADO The DCO should also send, by e-mail or fax, a brief summary of the sample collection

session to the ADO The DCO will use an ADO-designated courier to return the paperwork to the ADO The DCO will follow ADO shipping and packaging instructions