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What Is an Emotional Support Animal (ESA) letter?
An Emotional Support Animal (ESA) letter is a clinical recommendation from a licensed mental health professional indicating that an individual may benefit from the emotional support and therapeutic presence of an animal as part of their mental health care.
ESA letters are intended for housing-related accommodations and do not provide public access rights as service animals.
We approach ESA evaluations in a thoughtful, ethical, and legal manner through an established therapeutic relationship. ESA letters are not automatically issued and are provided only when clinically appropriate.
Our Process
Initial Assessment
Clients begin with a comprehensive intake assessment to review:
current symptoms
emotional functioning
mental health history
treatment needs and goals
In addition to the required intake, Clients will need to attend four consecutive therapy sessions once a week to determine whether an ESA recommendation is clinically appropriate within the context of ongoing treatment.
Ongoing Therapy Requirement
To support ethical and clinically appropriate recommendations, clients must:
complete the intake assessment
attend a minimum of four consecutive weekly therapy sessions
This allows time to establish a therapeutic relationship and determine whether an ESA recommendation is clinically appropriate within the context of ongoing treatment.
Documentation
Only If/when clinically appropriate, an ESA letter will be provided following the assessment process and treatment period.
Please note:
ESA letters are not guaranteed
documentation is based on clinical judgment and medical necessity
additional forms or documentation requests may require additional fees
Fees
ESA documentation is a separate private-pay service and is not included in standard therapy session fees or covered by insurance.
ESA Letter Fee: $100
In addition to the required intake and four therapy sessions.
State Restrictions
ESA letters are valid only within the state where the client resides at the time of treatment - during the intake evaluation and consecutive therapy sessions.
Moving to a new state invalidates the existing letter for housing accommodations and is outside of the therapist's practicing jurisdiction.
Clients must request a new letter that accurately documents the specific legal terms and active licensure for the new location by a therapist that is licensed in that state.
A new letter request and updated documentation are required even if the current clinician is also licensed in the new state.
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