How to Get an ESA Letter in Missouri: A Complete Guide

Like many other American states, Missouri is a welcoming place for assistance animals of all kinds. But it also differentiates different assistance animals, most notably service animals and emotional support animals.

Service animals have legal protection, having gone through training to perform a specific task. Their legal status is to avoid discrimination against people with disabilities.  

Emotional Support Animals differ from service animals. An ESA supports individuals in their daily lives, but they haven’t trained to perform specific tasks or duties.

The only item necessary in Missouri to have your emotional support animal recognized and accepted is an official ESA letter.

Do You Qualify for an ESA Letter in Missouri?

You may qualify for an ESA letter in Missouri if you have a recognized psychological or emotional condition. This diagnosis is subject to an independent assessment and verification by a licensed mental health professional or LMHP.

Some of the conditions that can qualify you for an ESA letter include the following:

  • Depression
  • Bipolar Disorder
  • Panic Disorders
  • Anxiety
  • PTSD or Post Traumatic Stress Disorder
  • Attention Deficit Disorder
  • Cognitive Disorders
  • Learning Disorders
  • Phobias and Fears

You cannot verify your condition; it must be subject to an impartial assessment that explores your issues and establishes how the ESA supports you with your daily life and any difficulties you encounter.

A proper assessment is essential, conducted by a medical professional appropriately qualified to issue your letter

Who Can Write an ESA Letter in Missouri?

Only a licensed mental health professional can provide you with a legitimate and certifiable ESA letter. 

Here is a list of some of the different types of licensed medical healthcare professionals who should be able to provide you with an ESA letter in Missouri:

  • Licensed Nurse Practitioner
  • Physician
  • Psychiatrist
  • Psychologist
  • Licensed Clinical Social Worker
  • Licensed Marriage and Family Therapist

If you use one of the many online organizations offering ESA letters in Missouri, then always check out who verifies the condition and produces the letter, as they need to be qualified to do so.

Watch out for companies who offer to produce a free letter; they might be bogus. Also, ESA letters are only valid for twelve months, so avoid advertisements offering letters for a more extended period or unlimited letters.

What’s Inside a Missouri ESA Letter?

Your ESA letter must contain certain specific information for it to be valid. The letter must include your practitioner’s full name and license number. They will also need to identify the state where their license was issued initially.

The letter must be dated and signed. An ESA letter is only valid for twelve months, so the date of issue is critical.

One of the rules of ESA letters is that they are issued every year following a new clinical assessment. The time limit on this is because health conditions change. It also acts as a safeguard against fraud.

The letter must be on your practitioner’s official letterhead rather than blank paper. 

Benefits of Getting an ESA Letter in Missouri

Without the benefit of legal status like a service dog, an ESA letter is the only way to verify the importance of your emotional support animal in your daily life. This letter can open doors in your everyday routine.

Avoiding Pet Fees for ESAs

Typically, pets incur extra charges and damage deposits if you rent an animal-friendly house or apartment. An ESA letter can often negate the extra costs usually associated with a pet because they are residents on a need basis.

Taking Your ESA to College or Work  

Employers and universities are not obliged to accept ESAs in your working or educational environment. Still, an ESA letter makes it more likely they will allow your ESA to accompany you.

An ESA letter can help open the conversation with an employer and may lead to an open door for your ESA.

Traveling in Missouri

Pets usually attract extra costs when traveling, but an ESA can be exempt from these or at least eligible for a reduction.

Going Out in Public in Missouri With an ESA

ESAs may receive the same accommodations as service dogs in Missouri, but this is discretionary and not a right.

Always check out public locations before you take your ESA, as access will vary across the state.

Emotional Support Animals Laws in Missouri

Like other American states, Missouri does not have specific legislation for Emotional Support Animals or ESAs. Missouri follows the federal law, which provides the following protections. 

Fair Housing Act

Missouri’s state-specific regulations for housing and ESAs follow federal legislation, covered by The Fair Housing Act (FHA)

Properties that don’t usually accept pets can’t refuse an ESA, provided the owner can show an official letter. However, if a pet is dangerous, disruptive, or continuously noisy, then ESA status is not outright protection. 

A landlord has to balance their duty to other residents with an obligation not to discriminate against you because of your ESA.

Americans With Disabilities Act

Most assistance animals at work in Missouri fall under the Americans with Disabilities Act.

The ADA allows service dogs in the workplace but not ESAs. However, many employers treat ESAs like service dogs and allow them into the workplace, providing you have a genuine ESA letter.

Air Carrier Access Act

ESAs used to be a protected class of animal, and an airline couldn’t prevent an ESA from traveling with you in the cabin under the auspices of the Air Carrier Access Act.

However, in January 2021, the DOT (Department of Transportation) came out with a new ruling that amends the Air Carrier Access Act, which states that ESAs are no longer a protected class of animals.

Airlines are no longer required to allow them on flights. In contrast, service dogs still have protection on flights with the correct documentary evidence and certification.

Check with your airline before you fly on their approach to ESAs.

How to Get an ESA Letter in Missouri: A Step-by-Step Guide

1. Contact an LMHP or Registered Healthcare Professional

Book an appointment with an LMHP, whether someone you regularly see for counseling and support or whom you might be reaching out to for the first time. You can contact the LMHP in person or online.

Establish whether this practitioner can issue an ESA letter if they are happy with their clinical assessment of your needs. It may be that your regular counselor or therapist does not fit the criteria to issue this type of letter.

The list of appropriate healthcare professionals is broad, so it should be pretty simple to find one that most suits your needs and arrange an appointment.

This process can be daunting if you haven’t ever discussed your psychological or emotional needs with anyone outside your close circle of family and friends. Take time to find the right professional, and choose someone you think you’ll gel with since it’s a big step. 

Try and find someone with training in the specific area you’re struggling with that an ESA may help alleviate. This is important for a professional assessment, so they fully understand your position.

Healthcare professionals are not there to judge you or make you feel uncomfortable, so your appointment for assessment shouldn’t feel like an interview or uncomfortable in any way.

2. Assessing Your Needs

Your medical professional will assess your situation. They need to understand how your ESA supports you in your daily life. It can be helpful to distill your thoughts about this before the appointment on a piece of paper or discuss it with a close friend or family member. 

Getting used to articulating why an emotional support animal is crucial to your life. Even just saying it out loud can help when you’re talking to someone you have never met before, especially if you are nervous.

If your appointment is with someone without prior knowledge of your mental health, then background and context will help them evaluate your situation.

It’s helpful to include your emotional support animal as part of a broader package of treatments, so you demonstrate you’re actively taking other steps to support yourself and not just relying on ESA status for your pet. A treatment program could include medication or therapy.

If your doctor is satisfied that your ESA is necessary to your lifestyle and that your needs are genuine, they can produce an official ESA letter.

If they aren’t familiar with the requirements, set out the essential elements the letter must contain to be valid. You might want to include this in a separate document, as they’ll probably write the letter after the appointment and send it to you.

If you feel that you’re not making progress and the medical professional doesn’t appear confident in your particular area. Ask for a referral to someone with more experience in this field.

3. Wait for Your ESA Letter to Arrive

Following a successful appointment, you just need to wait for your ESA letter to arrive. Most medical professionals are prompt, and you should receive it within a few days to a week.

On receipt, check the letter carefully to ensure it satisfies all the relevant criteria. We’ve provided a comprehensive list of all the points, so you can check your letter against this.

Contact your medical professional if any information is incorrect or missing key elements.

4. Registration of Your ESA Letter 

Fill out the short form on the ESA Registration of America homepage. You’ll need details like a photo of your animal.

Registration is not a requirement under Missouri law. However, it makes it easier to demonstrate that your ESA has an official status and isn’t just a household pet.

The registration should identify your pet. Best of all, registration is completely free.


If you have an ESA in Missouri, you’ll need an official ESA letter to protect a companion essential to your emotional well-being and mental health.

ESAs are much more common now, but some people are still uninformed or suspicious about bogus claims. An ESA letter can offset that.

Make sure your ESA has the official recognition they deserve, and sign up today for an assessment and registration through the ESA Registration of America.