What is the difference between an emotional support animal and a service animal?

Service animals are trained to perform specific tasks for people with disabilities and are protected under the ADA for public access. Emotional support animals (ESAs) provide comfort through companionship but don't require specific training. ESAs are protected under the Fair Housing Act for housing accommodations but do not have public access rights. Airlines no longer recognize ESAs for travel.

Who can write an emotional support animal letter?

ESA letters must be written by a licensed mental health professional (psychiatrist, psychologist, licensed clinical social worker, or licensed professional counselor) who has an established treatment relationship with the patient. Letters from providers who have only conducted a brief online evaluation may not be accepted by housing providers.

What must an ESA letter include to be valid?

A valid ESA letter must include: provider's letterhead with license information, statement that patient is under their care, confirmation of a mental health condition that qualifies as a disability, statement that the ESA is necessary for the patient's mental health, provider's signature and date, and the letter should be dated within the past year.

Can a landlord deny an emotional support animal request?

Landlords must provide reasonable accommodation for ESAs under the Fair Housing Act unless: the animal poses a direct threat to safety, would cause substantial property damage, or the housing has 4 or fewer units with the owner living in one. Breed and size restrictions generally do not apply to ESAs.

Are ESA letters still valid for airline travel?

No. As of January 2021, the U.S. Department of Transportation no longer requires airlines to accommodate emotional support animals. Airlines may now treat ESAs as pets and charge applicable fees. Only trained psychiatric service dogs and other service animals are protected for air travel.

Emotional Support Animal Letter Template - ESA Documentation

Administrative — Emotional Support Animal Letter Template

Administrative Psychiatry Updated: 11/7/2025

The Emotional Support Animal Letter Template is designed for psychiatrists, psychiatric nurse practitioners, and mental health providers writing letters to support patient requests for emotional support animals (ESAs) in housing or travel. This template provides the structured format required by housing providers and airlines while maintaining clinical appropriateness and avoiding fraudulent documentation. The template includes sections for patient demographics and diagnosis, clinical relationship and treatment history, functional limitations and how ESA addresses them, professional opinion on ESA necessity, and provider attestation. This template ensures appropriate ESA documentation, supports legitimate patient needs, maintains clinical integrity, and protects providers from inappropriate requests. The template emphasizes clinical necessity and avoids language that could be misused. Ideal for psychiatric practices, mental health providers, and practices receiving ESA letter requests from established patients.

Letter Header

Provider name, credentials, practice name
Address, phone, fax, NPI, license number
Date

Patient Information

Patient name, DOB
Diagnosis: [Primary psychiatric diagnosis]
ICD-10 code: [Code]

Clinical Relationship

Patient under my care since: [Date]
Treatment: [Type and frequency]
Last visit: [Date]

Clinical Assessment

Functional limitations: [How mental health condition affects daily life]
How ESA addresses limitations: [Specific benefits of ESA for this patient]
Clinical necessity: [Professional opinion on ESA necessity]

Provider Attestation

I certify that [patient name] has a mental health condition that causes functional limitations and that an emotional support animal would provide therapeutic benefit. This letter is based on my professional assessment as the patient's treating mental health provider.

Important Notes

This letter is for established patients only
Requires ongoing treatment relationship
ESA is different from service animal
Housing providers may have specific requirements

Provider Signature

[Signature, credentials, license number, date]

Administrative — Emotional Support Animal Letter Template

Template