My oldest DD has had to petition to Regionals twice now and both times her petitions have been accepted. Last year she had back spasms and a note from her physical therapist was accepted. This year it is a concussion and she was just cleared yesterday by her doctor. This year we were told that she would have to be cleared 10 days prior to Regionals for her petition to be accepted. In addition to the medical notes, you also have to meet score requirements for your region and the petitions have due dates too.