How To Ask A Doctor For An ESA Letter

Emotional support animals (ESA) are a lifeline to people all over the United States. 1 in 5 Americans now suffer from a mental illness – and if you’re among them, you might find the presence of your pet hugely comforting. 

So how can you get your cat or dog recognized as an official ESA? 

The first step is to ask your doctor or licensed mental health professional (LMHP) for an ESA letter. This is a document which confirms that you suffer from a mental disorder and that your pet is crucial to your emotional wellbeing. 

This letter will protect you under federal law. This means you’ll be exempt from rules which would prevent your pet from accompanying you onto an airplane or living with you in certain housing. 

Here, we will guide you through the process of asking your doctor for an ESA letter. 

How To Ask A Doctor For An ESA Letter: Step-By-Step

Step 1: Arrange A Consultation With Your Doctor 

The first stage of the process is to book an appointment with your local practitioner. If you’ve never discussed your mental health with your doctor before, it’s understandable that you might feel anxious. But it’s important to be honest about how you’re feeling. 

Your doctor needs to confirm that you meet the criteria outlined by the Americans with Disabilities Act of 1990, and have a condition that’s listed in the Diagnostic and Statistical Manual of Mental Disorders (Version 5). 

Among others, these include: 

  • Depression
  • Anxiety
  • Attention Deficit Disorder (ADD)
  • Post-Traumatic Stress Disorder (PTSD)
  • Social Anxiety 

You’re also eligible for an emotional support animal if you have autism or dyslexia or if you find that your pet supports you through stressful situations which you’d have difficulty managing without them. 

If you’re worried about your appointment, you might find it helpful to write notes beforehand so you don’t forget anything important you wanted to mention. 

Step 2: Talk To Your Doctor Or Licensed Mental Health Professional 

At your appointment, the best course of action will depend on whether or not your doctor is already treating you for your mental condition 

If this is the first time you’ve mentioned that you’re struggling, you might also like to discuss alternative treatments such as therapy and medication. There’s been an unfortunate increase in the number of people trying to get their pet registered as an emotional support animal purely to take them on airplanes – so talking through other options will show your doctor that you’re serious about finding the best treatment for you. 

It might be that your doctor isn’t qualified to advise you on mental health. If this is the case, ask them to refer you to a mental health professional (such as a therapist, counselor or psychiatrist) that will be able to help you get an emotional support animal letter instead. 

This is also a good step to take if you feel that your doctor is being dismissive. Some physicians are reluctant to issue legitimate ESA letters because of the increase in fraudulent applications, so make sure you can talk to somebody with experience of prescribing emotional support animal letters

If you’re already in therapy, you can go straight to your licensed mental health professional, rather than speaking to your general doctor. Your LMHP may or may not confer with your doctor before approving your ESA letter. 

Can I Talk To An LMHP Online? 

When trying to get an ESA letter, the only rule is that it must be provided by a licensed healthcare professional. If you can’t see a therapist in person for whatever reason, you can organize an appointment with (or ask your doctor to recommend) a therapist who works remotely. Make sure to check they’re licensed in your home state. 

The US Department of Housing and Urban Development (HUD) has officially stated that online mental health professionals are able to prescribe emotional support animal letters. This means that landlords can’t discriminate against you if your letter is from an online professional as opposed to your family physician. 

Step 3: Getting Your ESA Letter 

Once your doctor or LMHP has agreed that you could benefit from an ESA, you should receive your emotional support animal letter quite quickly. When it arrives, it’s a good idea to double check that it includes all the information it needs to. 

A valid ESA letter should contain the following: 

  • The letterhead and signature of your physician or licensed mental health professional
  • Details of their license (such as the date of issue, state, and license number)
  • Address of their practice (or home address if they work remotely)
  • Confirmation that you suffer from a mental health condition and will benefit from an emotional support animal
  • An official ‘prescription’ (or recommendation) for the registration of your emotional support animal

The name, species, and breed of your emotional support animal 
If your ESA letter is missing any of these elements, it won’t be valid. Your professional should know what to include, but double check everything to be sure. 

Step 4: Paying For Your ESA Letter 

The cost of your emotional support animal letter will vary state by state. Typically, this can be around $200. Remember that your travel letter will only be valid for a year. If you feel you still need an emotional support animal after this period, you’ll need to pay this sum again to renew your letter. Housing letters do not need to be renewed.

What To Look Out For When Getting An ESA Letter? 

1) Getting A Fake ESA Letter Online 

Unfortunately, we’re seeing more businesses that offer quick access to automatic ESA letters online. These aren’t valid ESA letters, as they haven’t been prescribed by a licensed healthcare professional. 

Look out for any sites which promise a suspiciously cheap (or expensive!) letter  with a ‘no questions ask’ approach. Because an emotional support animal is considered a form of treatment, it’s impossible to get one without talking to a physician or licensed mental health professional about your mental health. 

If you’re asking a remote therapist for an ESA letter, check their credentials and make sure they’re licensed in your state. A letter issued by a professional who isn’t accredited won’t be valid. This means you won’t be able to take advantage of the policies that protect your right to stay with your emotional support animal: 

  • Federal Fair Housing Act (FHA): Under this act, you can’t be evicted from or denied housing because of your ESA. As emotional support animals don’t count as pets, landlords with a ‘no pets’ policy can’t reject your application on this basis.
  • Air Carrier Access Act (ACAA): This act allows you to take your emotional support animal into an airplane cabin while traveling. (Remember your airline may have restrictions in place about the size or species of animal you can bring). 

2) Companies Which Refer To ESAs As ‘Service Animals’ 

Remember that the only true way to register your pet as an ESA is to receive a valid letter. Companies are allowed to offer ID cards, harnesses, or registrations for your pet, but this simply isn’t enough for an ESA to be considered valid. Still, these products can help those with valid ESA’s live an easier life.

You might like to buy your pet a harness or ID once you’ve got your letter, but these are not an alternative and won’t qualify your animal as an ESA on their own. A reputable company will also know that ESAs are not the same as service animals (such as a seeing eye dog or seizure alert dog) and won’t refer to them as one.

Not only do these fraudulent businesses undermine those who genuinely need an ESA or service animal, they can also get you into a lot of trouble. 

Identifying pets as service animals, rather than emotional support animals, is a criminal offense in nearly every state. In California, Florida, and Michigan, this is punishable by imprisonment as well as a hefty fine. 

3) Being Pushy With Your Doctor 

If you feel that an emotional support animal will improve your quality of life, it can be incredibly frustrating to be denied a letter by a doctor. However, getting angry or upset at them is not the answer. 

Many doctors are simply reluctant to prescribe letters because of the rise in dishonest applications. They might be concerned that your top priority isn’t your mental health, but taking advantage of the Fair Housing Act or Air Carrier Access Act. 

If your doctor believes that treatments such as medication or therapy would be a better alternative to emotional support animals, you’re going to have to accept their professional opinion. 

Don’t let the experience put you off from going through the proper procedure! After being denied a letter, it can be tempting to visit a site which promises instant approval for registering your pet as an emotional support animal. But this will cause problems in the long-run. 

If you truly believe that an emotional support animal is vital to your wellbeing, a licensed mental health professional should recognize that and prescribe a letter quickly.


There’s no reason to put off asking your doctor for a valid ESA letter. As long as you follow the right procedure, you (and your pet) can enjoy peace of mind when you’re out and about in public. 

Don’t be taken in by online offers that are too good to be true. Contact a real professional at ESA Registration today.