Emotional support animal letter template: a guide for mental health professionals

Key Takeaways: 

• An emotional support animal (ESA) letter is a clinical document with legal implications that details the presence of a qualifying disability and the need for a support animal. 
• An ESA allows for housing accommodations under the Fair Housing Act. 
• With an ESA, a client may live with an animal in housing with pet restrictions and avoid pet-related fees. 
• ESA letters do not grant public access rights or airline accommodations.
• Detailed clinical reasoning and documentation to support the letter are important. 

Emotional support animals (ESAs) are important for many people who face mental health challenges. If your client asks for an ESA letter, you must understand how to balance their well-being with ethical compliance. Learn how to write an ESA letter and how to protect yourself if its validity is questioned.

What is an emotional support animal letter — and who can provide one?

An Emotional Support Animal (ESA) letter is a document from a licensed healthcare professional. It confirms that a person has a qualifying mental health disability and needs an emotional support animal. It allows the animal to live in apartments and other places with pet restrictions. It also exempts the owner from pet-related fees under the Fair Housing Act.

Only licensed mental health professionals (LMHPs) or specific licensed medical providers can issue valid ESA letters. The provider must be licensed in the individual's state and have evaluated their condition.

Providers who can issue these letters include:

• Mental health professionals, such as psychologists, psychiatrists, licensed clinical social workers and licensed professional counselors.
• Psychiatric mental health nurse practitioners or other advanced practice nurses working in mental health care.
• Specialized therapists, like licensed marriage and family therapists (LMFTs).

Additionally, primary care physicians and general practice doctors may provide an ESA letter for a patient.

The differences between ESAs, service animals and therapy animals

Emotional support animals, service animals and therapy animals are not interchangeable terms. There are distinct differences between these three categories.

• Emotional support animals provide therapeutic benefits to someone with a diagnosed mental health condition through companionship and affection. They are protected under the Fair Housing Act.
• Service animals, protected under the Americans with Disabilities Act, are "working animals" and not pets. Examples include guide dogs for the blind, medical alert dogs for seizure disorders and psychiatric service dogs that assist with panic attacks.
• Therapy animals are not covered by major federal disability laws. They work as a team with their owner to volunteer in places like hospitals, schools or nursing homes to provide comfort to many people, not just the owner.

What an ESA letter does and does not legally grant

An ESA letter legally grants:

• The right to live with your animal in housing that has a "no pets" policy.
• Exemption from pet-related costs (like pet rent and fees).
• Exemption from pet-specific breed, size, and weight restrictions unless the animal poses a direct threat or undue burden.

These protections apply only when the letter confirms that the person has both: 

• A qualifying disability, and
• A need for the animal (must be disability-related) 

An ESA letter does not provide legal access to places where pets are restricted (like restaurants or stores).

Under federal law,  airlines are not required to accommodate emotional support animals as service animals. Most major carriers now treat ESAs as pets under their standard policies.

Why ESA letters require careful clinical judgement

The ESA letter requirements for mental health professionals are strict. Providing a client with an ESA letter is a significant disability determination that has real legal (and ethical) consequences. They require careful clinical judgment and should never be treated as mere administrative favors.

It's crucial to properly evaluate your client before issuing an Emotional Support Animal (ESA) letter. Mental health professionals must document specific functional impairments to prevent the misuse of ESA letters. Simply wanting a cherished pet around is not sufficient justification for a letter.

Unfortunately, ESA letters are increasingly commodified by online services that promise instant approval without a proper evaluation. These practices undermine professional integrity and increase the ethical and legal risk for licensed providers. Ethical ESA determinations require careful assessment, clinical judgement, and strong documentation, not volume-driven approvals.

Legal and documentation considerations clinicians should know

The Fair Housing Act governs ESAs, requiring housing providers to make "reasonable accommodations" for individuals with disabilities, such as waiving "no pet" policies and fees. The ESA letter establishes the connection between the client's disability and the need for the animal.

Federal law does not recognize any official ESA certification, ID card or registration. In most cases, you must be licensed in the client’s state to ethically and defensibly provide an ESA letter, and some states require a minimum 30-day therapeutic relationship before you can provide one.

If a housing provider were to challenge an ESA request, then the quality of the letter you provided will determine whether your client's rights are upheld or if you will face professional scrutiny.

What a compliant ESA letter should include

Each part of an ESA letter serves a specific purpose, like verifying legal status or establishing your professional credibility. Some of the key components of an ESA letter include:

• The client's name and contact information
• Your credentials
• A therapeutic relationship statement
• Confirmation of a qualifying disability
• Clinical rationale that links ESA support to functional impairment

You should also include the date, signature and your professional contact details.

What to avoid in an ESA letter

Including misleading information can weaken your letter's legal validity, compromise client privacy and expose you to liability. Here are some things you should avoid when writing your letter:

• Mentioning a specific diagnosis or health-related information is not required. Instead, the letter should state that the person has a qualifying disability without naming the diagnosis.
• Including a registry or certification number (there is no legal standing for these, and they may be fraudulent).
• Making claims about the animal's temperament or training (evaluating their pet's behavior is outside of your clinical expertise).
• Using language that defines the ESA as a "service animal" (these two terms are not interchangeable).

Avoid excessive technical jargon to improve the letter's readability. A notarization isn't necessary. Your professional letterhead, license number and signature are enough to verify its authenticity.

ESA letter template examples for mental health professionals

An ESA letter does not need to be lengthy or complicated. It should include all the relevant information necessary to be deemed credible. Here is an example of an emotional support animal letter template for therapists that is written for a property manager:

[Date issued]

To [property manager, landlord]

I am a licensed [your license type] in the state of [state of licensure], license # [give your license number].

I am currently providing mental health services to [state your client's name].  I have an established therapeutic relationship with them.

Based on my clinical evaluation, [client’s name] has a mental health-related disability that substantially limits one or more major life activities. As part of their ongoing care, I have determined that the presence of an emotional support animal helps support their ability to function in daily life.

For this reason, I am recommending that [client’s name] be granted a reasonable accommodation to reside with their emotional support animal, in accordance with the Fair Housing Act.

If you have questions related to this accommodation request or require verification of this recommendation, please contact my office using the information below.

Sincerely,
[Your Signature]
[Printed name, professional credentials]
[Name of practice]
[Business address]
[Phone number]
[Professional email]

This is just one example of an emotional support animal letter. Remember, for HIPAA-compliant ESA letters, you must cite relevant federal laws that back up your client's rights to an ESA (like the Fair Housing Act) without identifying their diagnosis. Most housing providers will also require updated letters that are dated within the last 12 months to prove there is a current need for an ESA.

Make sure you include your letterhead, essential details and contact information. Do not use any language concerning registries or your client's specific diagnosis (but do confirm that there is an existing disability). 

How to document ESA determinations ethically in your notes

As a mental health professional, your integrity forms the foundation of your ESA letter-writing practices. To ensure a genuine need exists, you should apply the same thoroughness as in any psychiatric disability assessment. Good documentation will support your clinical reasoning and protect you legally if challenged.

Document the start date and frequency of sessions with your client. Notes should detail how their disability affects daily activities, using objective tools to connect assessments and clinical goals. 

You should also include the potential positive impact of an ESA on their mental health. For example, if your client has bipolar disorder, you might document how caring for their emotional support animal (cat) supports their daily routine and structure, which complements their interpersonal and social rhythm therapy treatment goals of using routine to support mood stabilization. 

Be consistent in your clinical notes and ESA letters. Structured notes offer a clear, objective record that supports your clinical judgement and protects your credentials from potential legal issues.

How Upheal supports responsible ESA documentation

To make an ESA determination, detailed documentation is essential. By ensuring alignment between your notes, assessments and letters, you can protect your credentials and ethical integrity. Upheal uses AI to enhance clarity without automating clinical decisions, while prioritizing ethical use over volume and speed.

Checklist: Before providing an ESA letter

Strict state laws and guidelines mean you'll have to ensure your ESA letter meets all ethical standards. Document the following things in your notes to ensure that you have met these standards. 

Use the following checklist to make sure your clinical determination is legally compliant and ethical.

1. Ensure you are licensed to practice in the state in which the client resides.
2. If you live in a state that has the "30-Day Rule," like California, make sure you've built the necessary therapeutic relationship.
3. Conduct a clinical assessment to justify the recommendation. It should be thorough and well-documented. 
4. Confirm that your client meets the criteria for having a qualifying mental health-related disability. The specific diagnosis should not be disclosed in the ESA letter itself.
5. Identify that their condition limits at least one major activity (work, sleep, etc.).
6. Establish the nexus (the link) that clearly describes how the animal helps ease certain symptoms of your client's disability.
7. Mention other treatments (like CBT or medication) and explain why an emotional support animal (ESA) is a needed addition to those treatments.

Keep this checklist in your client's record as evidence of your due diligence for the ESA letter's validity.

Conclusion: Clarity, care and clinical integrity

ESA letters should support the genuine needs of your clients. Remember, templates are tools to make the documentation process more streamlined. They are not intended to be shortcuts. Strong, consistent documentation protects not only your professional integrity, but your client's privacy too. 

Upheal can help clinicians document complex decisions with care. The AI-powered platform not only streamlines your note-taking but also provides access to customized AI prompts and templates. 

This makes ESA documentation for therapists more organized and efficient, allowing you to easily find the information you need to support your letters. With these tools, you can focus more on delivering compassionate, high-quality care to your clients.  

If you are interested in more advanced documentation features, explore Upheal’s pricing.   

Explore practical tips and resources for therapists and behavioral health professionals on the Upheal blog.