How getting an ESA letter works

First, book an appointment. You'll confirm which state you live in, since our therapists may evaluate you only where they're legally allowed to practice. There's no cost to book.

You'll be asked a few questions about how you've been feeling and about your animal. This helps the therapist prepare, and it keeps your appointment short.

The evaluation itself is a brief conversation with a licensed therapist, usually 5 to 10 minutes, over phone or video. Our mental health evaluations are handled by Gabriel Warner, LCSW, whose license is in clinical social work.

Expect questions about your symptoms, the ways they show up in everyday things like sleep, work, school or looking after yourself, and what your animal does for you. There's no script to prepare. Candid, concrete answers help the most.

Not everyone who books will receive a letter. An ESA letter is a clinical decision, and the therapist only issues one when it's appropriate.

If the clinical findings point toward an ESA, the letter goes through review and signing. That step belongs to Andrew Patel, M.D., our physician, who looks over evaluations and signs an ESA letter whenever the findings support it.

The letter shows the therapist's name, their type of license and license number, the issuing state and the date. In it, the therapist explains why your disability makes the animal necessary without revealing your diagnosis or medical records.

When a letter is issued, you pay and get the signed ESA letter as a PDF, typically on the same day. Pricing is $129 for up to 2 animals or $199 for 3 or more, and a college housing letter is $129.

If the therapist decides against issuing a letter, there's no charge. There's no subscription either.

Hand the letter to your housing provider together with your request for a reasonable accommodation, put in writing, for example asking that a no-pets rule be waived for your animal. The Joint Statement that HUD and the Justice Department issued in 2004 lets a provider seek reliable information when it isn't apparent that you have a disability or need the animal, but generally bars questions about your diagnosis or its severity.

Under guidance HUD released in May 2026, each untrained emotional support animal request gets an individual review, and HUD's 2020 notice, FHEO-2020-01, stopped being in effect as of September 17, 2025. Your state may offer more protection, so check your state guide. Your letter supports your request, but the decision rests with the housing provider and the law that applies.

A little preparation helps the appointment go smoothly. Find a quiet, private place where you can talk freely, and check that your phone or camera works.

Jotting down a few notes ahead of time can help: the symptoms that weigh on you most, when they began, how they affect your sleep, work, school or relationships, and particular moments when your animal helped. If you've been in counseling or taken medication, feel free to mention it, though no records are needed.

If you have more than one animal or need a college housing letter, say so when you book so the therapist can consider each request. If your school or landlord has its own verification form, mention that too.

California has an extra step. AB 468 requires a client relationship of at least 30 days and a clinical evaluation before documentation for an emotional support dog is issued.

After your first evaluation, you get a same-day letter of intent. Around day 30, you have a follow-up with the therapist, and if an ESA is still appropriate, your ESA letter is issued.

We don't sell registrations, certificates, ID cards or vests, since none of them carries legal weight. Our letters are for housing. They won't get your animal into stores, restaurants or offices, because the ADA doesn't classify ESAs as service animals. Airlines, for their part, have been free to turn ESAs away since 2021.

An ESA letter is no replacement for mental health treatment, either. In a crisis, dial or text 988; in an emergency, dial 911.