ESA letter template: a clinician's guide

In this article▾

1. What this guide covers
2. What is an ESA letter?
3. What should an ESA letter establish?
4. ESA letter template for clinicians
5. How should you customize the opening?
6. How should you describe the patient?
7. Should you include the diagnosis?
8. How should you describe the animal's role?
9. What should you assess before writing the letter?
10. What belongs in the clinical record versus the ESA letter?
11. What should you leave out of an ESA letter?
12. Is an ESA letter the same as a service-animal letter?
13. Can you use the same ESA template for every state?
14. What should California clinicians add to this template?
15. Does HUD require a specific ESA letter format?
16. What if the landlord gives you a form?
17. What if the patient gives you an ESA letter they found online?
18. What are the most common ESA letter mistakes?
19. How should you document the assessment behind an ESA letter?
20. Can an ESA letter include the animal's name?
21. Should you state that the ESA is part of the treatment plan?
22. Should you cite the Fair Housing Act in an ESA letter?
23. What if you do not believe an ESA is clinically appropriate?
24. What if the patient needs the letter urgently?
25. How can AI help you write an ESA letter?
26. What should you check before signing an ESA letter?
27. ESA letter template: quick version
28. Frequently asked questions about ESA letter templates
29. Final ESA letter checklist
30. Sources

An ESA letter is easy to find online. A clinically defensible one is harder.

Patients often arrive with a landlord's form, a letter they found online, or a request to "just sign something saying my dog is an emotional support animal." For clinicians, the task is different. You are documenting a professional opinion about a patient's disability-related need, not certifying a pet.

This guide gives you a copyable ESA letter template, explains what each section is doing, and shows you what to assess before signing it.

For housing, the Fair Housing Act is the framework, and a housing provider may ask for reliable disability-related information when the disability and the need for the animal are not obvious. What changed in 2026 is federal enforcement, not the statute: HUD withdrew its 2013 and 2020 assistance-animal guidance and now pursues reasonable-cause findings only where the animal is individually trained. We covered that in what HUD's ESA guidance rescission means for clinicians.

The template below is therefore designed as a clinician's starting point, not a universal legal form. State requirements can add conditions. California, for example, requires practitioners providing documentation about an individual's need for an emotional support dog to meet specific licensing, relationship, and clinical-evaluation requirements, which we walk through in California AB 468: ESA letter requirements for clinicians.

What this guide covers

• A copyable ESA letter template, and what each section is doing
• What to include, leave out, and individualize for the patient
• How to document the assessment that sits behind the letter
• Where state requirements change the template, and the mistakes that cause problems

What is an ESA letter?

An ESA letter is clinical documentation from a qualified healthcare or mental health professional supporting a person's disability-related need for an emotional support animal or assistance animal.

The letter is not a certificate that makes an animal a service animal.

For housing purposes, the broader term is assistance animal, and the reasonable-accommodation duty sits in the Fair Housing Act itself rather than in agency guidance. HUD's 2020 guidance, which said an assistance animal can provide emotional support that alleviates one or more identified effects of a disability, was withdrawn in 2026. The statute and its regulation were not touched.

Sources: 42 U.S.C. § 3604(f)(3)(B) · 24 C.F.R. § 100.204 · HUD FHEO enforcement memorandum, May 22, 2026 · 91 FR 17291 (April 6, 2026)

That distinction matters because the same animal can fall under different legal frameworks depending on the setting.

A clinician writing an ESA letter should therefore focus on the part they can actually evaluate:

Does the clinical information support a disability-related need for the requested animal accommodation?

The letter should document your answer.

It should not promise a particular legal outcome.

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What should an ESA letter establish?

A useful ESA letter connects the patient's clinical situation to the requested accommodation without turning the document into a complete medical record.

At minimum, the letter should make clear:

• Who you are: Your name, credentials, license information, and professional contact details.
• Who the patient is: The patient whose clinical need you are documenting.
• Your relationship: That you provide or have provided professional care to the patient, where relevant.
• Clinical basis: The condition, symptoms, or disability-related information relevant to the request.
• Functional impact: How the condition affects the patient's functioning.
• Animal-related need: Why, based on your clinical evaluation, the animal is relevant to that disability-related need.
• Requested accommodation: What accommodation you are recommending.
• Your professional opinion: A clear statement that reflects your actual clinical judgment.
• Authentication: Date, signature, and appropriate professional information.

The question a housing provider is actually deciding is whether there is a disability and a disability-related need for the animal. A letter that simply says "my patient needs this dog for emotional support" gives the recipient very little to work with on either point.

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ESA letter template for clinicians

The following template is designed to be copied into your practice document and customized.

Do not sign it as written without reviewing every statement. The bracketed fields are prompts, not language you should automatically retain.

• [CLINICIAN NAME, CREDENTIALS]
• [LICENSE TYPE AND LICENSE NUMBER]
• [LICENSE JURISDICTION]
• [LICENSE EFFECTIVE DATE, IF REQUIRED]
• [PRACTICE NAME]
• [ADDRESS]
• [PHONE]
• [EMAIL]

Date: [DATE]

Re: [PATIENT FULL NAME]

To Whom It May Concern:

I am [CLINICIAN NAME], a licensed [PROFESSION/CREDENTIAL] providing behavioral health services in [STATE/JURISDICTION]. I have been providing professional care to [PATIENT NAME] since [DATE / DURATION OF RELATIONSHIP].

Based on my clinical evaluation and my professional relationship with [PATIENT NAME], I understand that they have [CLINICAL CONDITION / DISABILITY-RELATED CONDITION OR SYMPTOMS] that affects [BRIEF DESCRIPTION OF RELEVANT FUNCTIONAL IMPACT].

As part of my clinical evaluation, I have considered [BRIEF DESCRIPTION OF RELEVANT CLINICAL FACTORS]. Based on the information available to me, it is my professional opinion that the presence of an emotional support animal is related to [PATIENT NAME]'s disability-related needs.

Specifically, [BRIEF, INDIVIDUALIZED EXPLANATION OF HOW THE ANIMAL'S PRESENCE PROVIDES SUPPORT RELATED TO THE PATIENT'S CONDITION OR FUNCTIONING].

I therefore recommend that [PATIENT NAME] be permitted to keep [ANIMAL / TYPE OF ANIMAL, IF RELEVANT] as an accommodation related to their disability, subject to the applicable housing provider's accommodation process and applicable law.

This letter documents my clinical opinion regarding the patient's disability-related need for the requested accommodation. It does not certify the animal as a service animal, certify animal training or behavior that I have not independently evaluated, or establish rights outside the applicable legal framework.

Please contact me at [PHONE / EMAIL] if additional information is needed and may appropriately be disclosed.

Sincerely,

• [CLINICIAN SIGNATURE]
• [CLINICIAN NAME, CREDENTIALS]
• [LICENSE TYPE / NUMBER]
• [LICENSE JURISDICTION]

Important: The template intentionally avoids promising that the patient is "legally entitled" to an animal or that the animal has public-access rights. Those are separate legal questions.

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How should you customize the opening?

Start with your professional identity.

The recipient should be able to determine who wrote the letter and how to contact you.

Include:

• Full name
• Professional credentials
• License type
• License number when required or appropriate
• State or jurisdiction
• Practice name
• Professional contact information
• Letter date

The same components show up in every credible version of this document: credentials, license information, contact information, the treatment relationship, the clinical rationale, the date and the signature. Our clinician's guide to ESA letters goes through each one in detail.

Why the license information matters

License information is not just decorative.

Some states have specific statutory requirements for ESA documentation. California, for example, requires practitioners covered by AB 468 to include the license effective date, license number, jurisdiction, and type of professional license in documentation concerning an individual's need for an emotional support dog (Health and Safety Code § 122318(a)(2)).

That means a national template should leave room for state-specific fields.

Do not build a template around the assumption that every state has the same requirements.

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How should you describe the patient?

Identify the patient clearly, but avoid unnecessary protected health information.

In most cases, the patient's full name is sufficient for identifying the subject of the letter.

Whether additional identifiers such as date of birth belong in the letter depends on the recipient's legitimate need, your practice policies, applicable privacy requirements, and the purpose of the documentation.

Avoid turning the opening paragraph into a mini medical record.

The recipient generally needs to know:

This clinician is treating this person.

They do not necessarily need:

This clinician has reproduced the patient's entire diagnosis and treatment history.

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Should you include the diagnosis?

There is no universal requirement that every ESA letter disclose a specific diagnosis.

The better question is:

What clinical information is necessary and appropriate to support the professional opinion?

Your assessment may contain more information than your letter.

For example, your clinical record might contain a detailed diagnostic history, symptom measures, treatment history, and differential considerations.

The letter may only need a focused description of the relevant condition and functional impact.

Diagnosis versus functional impact

A diagnosis alone can be too thin.

Consider the difference:

"The patient has generalized anxiety disorder and needs an emotional support animal."

versus:

"The patient's anxiety symptoms interfere with daily functioning, and based on my clinical evaluation, the presence of the animal provides support related to those symptoms."

The second statement begins to explain the clinical reasoning.

Your actual wording should be based on your assessment.

Do not add a functional limitation simply because a template contains one.

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How should you describe the animal's role?

This is often the most important clinical section of the letter.

Avoid generic statements such as:

"The animal provides comfort."

Instead, describe the clinically relevant relationship you actually assessed.

Depending on the patient, the animal may:

• Help reduce distress associated with specific symptoms
• Support daily routines
• Provide a stabilizing presence during episodes of distress
• Support behavioral activation
• Help the patient maintain routines or activities
• Reduce the effects of a particular symptom or functional limitation

The specific relationship should come from your assessment.

Do not assume that an animal is clinically indicated simply because a patient reports enjoying its company.

The question is whether the animal is related to a disability-related need that you can professionally support.

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What should you assess before writing the letter?

The letter should come after the clinical assessment, not before it.

A practical assessment can cover five areas. Our clinician's guide to ESA letters has the longer version, including how to handle a request you end up declining.

1. What condition or symptoms are relevant?

Identify the mental or emotional condition that forms the basis for your professional opinion.

Depending on your profession and documentation standards, this may include:

• Diagnosis
• Relevant symptoms
• Duration
• Severity
• Course
• Treatment history

Do not diagnose solely to satisfy a letter request.

2. How does the condition affect functioning?

Move beyond the diagnostic label.

Consider:

• Daily activities
• Sleep
• Social functioning
• Concentration
• Emotional regulation
• Leaving the home
• Maintaining routines
• Other clinically relevant areas of functioning

3. What does the animal actually do?

Ask the patient to describe the animal's role.

Useful questions include:

• What changes when the animal is present?
• What happens when the animal is not present?
• Which symptoms are affected?
• What does caring for the animal contribute to daily functioning?
• How long has the patient experienced this effect?
• Is the effect consistent or situation-specific?

4. What accommodation is being requested?

A patient might say:

"I need an ESA."

That is not specific enough.

Ask what they actually need.

For example:

• Permission to keep the animal in housing with a no-pet policy
• Waiver of a pet restriction
• Documentation for a housing accommodation request

Do not assume the patient is asking for public access.

5. Can you support the conclusion?

At the end of the assessment, you should be able to answer:

"Would I be comfortable explaining the clinical basis for this recommendation to another qualified professional?"

If not, do not let the template make the decision for you.

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What belongs in the clinical record versus the ESA letter?

Your clinical record and your outward-facing letter serve different purposes.

The chart should support the letter.

The letter should not attempt to reproduce the chart.

This distinction also makes future documentation easier. If a housing provider requests clarification, you can return to the underlying clinical record rather than trying to reconstruct your reasoning from the letter.

If you already use structured treatment-plan documentation, keep the same principle here: document the clinical reasoning in the record, then produce the narrower external document from that record. The same split is worth building into intake, which is where digital patient intake forms earn their keep: structured information goes in once, and the outward-facing document is assembled from it.

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What should you leave out of an ESA letter?

More information does not automatically make a letter stronger.

Avoid including:

• Detailed trauma history
• Unrelated diagnoses
• Full medication history
• Family history
• Psychotherapy process notes
• Detailed session content
• Information about other people
• Speculation about the animal
• Claims about animal training you cannot verify
• Legal conclusions outside your role

Avoid unnecessary diagnostic detail

If the accommodation can be supported without disclosing a highly sensitive piece of clinical history, consider whether including it is necessary.

Your patient's privacy is part of good documentation.

Avoid legal guarantees

Do not write:

"This letter guarantees that my patient can take this animal anywhere."

An ESA letter does not automatically establish public-access rights.

The DOJ's ADA framework defines a service animal differently: a dog individually trained to do work or perform tasks for a person with a disability. Emotional support alone does not make an animal an ADA service animal.

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Is an ESA letter the same as a service-animal letter?

No.

This distinction should be clear in your documentation.

An emotional support animal and an ADA service animal operate under different federal frameworks.

Under the ADA, a service animal is a dog individually trained to perform work or tasks for a person with a disability. Emotional support, comfort, or companionship alone does not satisfy that definition.

Housing law is different.

The Fair Housing Act has no training requirement in it. It requires reasonable accommodations in rules, policies, practices or services when necessary to give a person with a disability equal opportunity to use and enjoy a dwelling, and a no-pets policy is one of the rules that can have to give way. HUD's federal enforcement posture narrowed in 2026, but the statute, private lawsuits under it, and state fair-housing laws did not change.

Sources: DOJ: service animals under the ADA · 42 U.S.C. § 3604(f)(3)(B) · what HUD's rescission changed

That is why your ESA letter should identify the purpose of the documentation.

If the patient asks for an ESA letter for housing, write a housing-oriented clinical document.

Do not turn it into a universal animal-access certificate.

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Can you use the same ESA template for every state?

No.

A national template can provide the structure.

It cannot guarantee state compliance.

California is an obvious example. AB 468 requires covered health care practitioners providing documentation concerning an individual's need for an emotional support dog to:

• Have a valid, active license
• Include specified license information
• Be licensed in the jurisdiction where the documentation is provided
• Establish a client-provider relationship for at least 30 days
• Complete a clinical evaluation regarding the need for an emotional support dog
• Provide the required notice concerning fraudulent service-dog representation

The Board of Psychology adds that AB 468 does not prescribe a specific number of meetings. The statutory requirement is a client-provider relationship of at least 30 days, with one exception: it does not apply to individuals who are verified to be homeless. Both board summaries predate the 2023 amendment and do not mention that exception, so work from the statute when it comes up.

A generic template cannot establish that relationship.

Your workflow has to do that.

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What should California clinicians add to this template?

If you are a California clinician covered by AB 468, your version should include the required license information and your workflow should confirm the 30-day relationship and clinical evaluation requirements before you issue the documentation.

Your letter should therefore contain fields for:

• License effective date
• License number
• Licensing jurisdiction
• Professional license type

You should also maintain documentation showing that:

• The client-provider relationship existed for at least 30 days
• You completed the required clinical evaluation
• The required notice was provided

California's Civil Rights Department separately explains that AB 468 did not change California fair-housing law or eliminate reasonable-accommodation rights for qualifying ESAs, and the statute says so itself. In July 2026 the department issued a legal alert reminding housing providers that state law still requires them to allow emotional support animals that have not been trained or certified, whatever HUD does federally.

Sources: Health and Safety Code § 122319(b) · CRD legal alert, July 20, 2026 · CRD: emotional support animals and fair housing law

The state practitioner requirements and the housing provider's obligations are related, but they are not the same question.

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Does HUD require a specific ESA letter format?

No. There is no HUD letter template, and there never was one.

What the Fair Housing Act asks is whether there is a disability and a disability-related need for the animal. Nothing in the statute or its regulation prescribes a format for the clinician's documentation, and HUD's withdrawal of its 2020 guidance did not create one either.

So treat any site selling a "HUD-approved ESA letter" as selling a format that does not exist.

There is no reason to add unnecessary language simply because an online template includes it.

Build your letter around:

Your professional identity → clinical relationship → relevant clinical basis → disability-related need → requested accommodation → authentication.

Then add state-specific requirements where applicable.

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What if the landlord gives you a form?

Review it before signing.

A landlord's form may ask for information that you can appropriately provide.

It may also contain statements that go beyond your role.

Check for:

• Diagnosis requests
• Treatment-history requests
• Animal-training certifications
• Legal conclusions
• Broad release language
• Statements about public access
• Statements that the animal is a service animal

You can provide appropriate clinical documentation without accepting every statement in a third-party form.

If the form asks you to certify something outside your professional knowledge, do not sign it simply because the patient needs it quickly.

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What if the patient gives you an ESA letter they found online?

Treat it as a draft, not as evidence.

Review each sentence.

Ask:

• Is this factually accurate?
• Is this based on my assessment?
• Does it accurately describe my relationship with the patient?
• Is the diagnosis statement appropriate?
• Is the functional-impact statement supported?
• Does the animal-related rationale reflect what I actually assessed?
• Does the letter make legal claims?
• Does it imply service-animal status?
• Does it contain state-specific requirements I have not verified?

A polished template can still contain language that is inappropriate for your patient.

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What are the most common ESA letter mistakes?

Mistake 1: Starting with the template

The clinician opens a template before completing the assessment.

Why it creates problems: The document starts driving the clinical reasoning.

Better approach: Assess first. Draft second.

Mistake 2: Treating diagnosis as proof of need

A patient has anxiety, therefore the patient needs an ESA.

Why it creates problems: The diagnosis does not explain the disability-related relationship between the patient and the animal.

Better approach: Document the relevant functional impact and animal-related clinical rationale.

Mistake 3: Using identical language for every patient

Every letter says the animal "provides comfort and emotional support."

Why it creates problems: It may not accurately reflect the patient's situation.

Better approach: Use patient-specific clinical language.

Mistake 4: Over-disclosing

The clinician includes the patient's complete history.

Why it creates problems: The recipient may not need that information.

Better approach: Keep the external letter focused.

Mistake 5: Certifying animal behavior

The clinician says the animal is trained, safe, or qualified.

Why it creates problems: The clinician may have no basis to make those claims.

Better approach: Document only what you can independently support.

Mistake 6: Promising housing approval

The letter says the landlord "must" accept the animal.

Why it creates problems: The clinician is making a legal conclusion rather than documenting a clinical opinion.

Better approach: State the accommodation you recommend and leave the legal determination to the applicable process.

Mistake 7: Treating an ESA as a service animal

The letter says the patient can bring the animal into public places.

Why it creates problems: ESA and service-animal frameworks are different.

Better approach: Keep the letter specific to its purpose.

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How should you document the assessment behind an ESA letter?

Your note can follow a simple structure.

ESA assessment note template

Reason for request. Patient requested documentation concerning an emotional support animal for [purpose].

Relevant clinical information. [Document relevant condition or symptoms and clinical context.]

Functional impact. [Document relevant effects on functioning.]

Animal-related support. Patient reports that [describe the animal's role and reported effect on symptoms or functioning].

Clinical evaluation. [Document assessment, observations, relevant history, and other information considered.]

Clinical rationale. Based on the information available to me, [support / do not support / defer] the requested ESA documentation because [clinical rationale].

Patient education. Discussed the distinction between emotional support animals and service animals, and the scope and limitations of the requested documentation.

Plan. [Letter provided / additional assessment planned / referral discussed / documentation deferred.]

This gives you a much stronger foundation than storing only the final letter.

It also makes your workflow easier to audit internally.

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Can an ESA letter include the animal's name?

Yes, when relevant.

Including the animal's name can make the letter more specific, but it is not automatically necessary.

For example:

"The patient has requested accommodation to keep their dog, Max, in their residence."

can be useful if the accommodation concerns a particular animal.

But you should not imply that you have independently evaluated the animal merely because you named it.

If you have not assessed the animal's behavior, training, or safety, do not make claims about those characteristics.

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Should you state that the ESA is part of the treatment plan?

Only if that is actually true.

Some online templates use language such as:

"The emotional support animal is part of my patient's comprehensive treatment plan."

That may be appropriate for some clinicians and patients.

It may be inaccurate for others.

Do not use "treatment plan" as a template phrase simply because it sounds clinically authoritative.

If the animal is genuinely integrated into the patient's treatment planning, document that relationship.

If it is not, describe the clinical rationale more narrowly.

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Should you cite the Fair Housing Act in an ESA letter?

You can reference the Fair Housing Act when appropriate to the purpose of the letter, but you do not need to turn the document into a legal memorandum.

A simple housing-oriented statement may be enough:

"I am recommending this accommodation in connection with the patient's disability-related need for an assistance animal in housing."

If you cite specific statutory language, verify it first.

Do not add legal citations simply to make a letter appear more authoritative.

Your professional credibility comes from your clinical assessment.

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What if you do not believe an ESA is clinically appropriate?

Do not write a letter you cannot support.

You can tell the patient:

"I understand why you're requesting the documentation. Based on my clinical evaluation, I don't have enough information to support the recommendation at this time."

You may then:

• Continue assessment
• Discuss other interventions
• Clarify the patient's goals
• Refer the patient where appropriate
• Reassess if clinically warranted

A patient request is not a clinical conclusion.

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What if the patient needs the letter urgently?

Urgency does not replace assessment.

A patient may have a move-in date approaching or a landlord requesting documentation within a few days.

You can acknowledge the deadline while maintaining your clinical standard.

A useful workflow is:

1. Confirm the purpose.
2. Check whether you have an appropriate clinical relationship.
3. Review relevant records.
4. Complete the evaluation.
5. Verify applicable state requirements.
6. Draft the letter.
7. Review every factual statement.
8. Sign only if the documentation reflects your professional opinion.

If you cannot complete those steps appropriately, do not allow the deadline to force a conclusion.

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How can AI help you write an ESA letter?

AI can be useful for drafting and checking, but the clinician should remain responsible for the clinical judgment.

This is particularly useful when the same practice writes multiple types of documentation. Instead of rebuilding the structure each time, you can give the system structured information and have it produce a first draft for review.

What AI can handle well

AI can help:

• Turn structured assessment information into a letter
• Organize the letter into consistent sections
• Remove repetitive wording
• Check whether administrative fields are present
• Adapt a practice-approved template
• Flag potentially overbroad legal statements
• Identify missing information for clinician review

What AI should not decide

AI should not independently determine:

• Whether a patient has a diagnosis
• Whether the patient has a disability
• Whether an ESA is clinically necessary
• Whether the animal is trained
• Whether a housing provider must approve the request
• Whether state-specific requirements have been satisfied

Those are questions requiring professional judgment, legal analysis, or both.

Where Supa fits

The workflow that saves real time is the one where the letter is assembled from documentation you already wrote, not typed from memory a second time.

Supanote turns a recorded, dictated or uploaded session into a structured note in a format you define, and you edit in plain English and sign off before anything leaves your hands. If the relationship date, the functional impact and the animal's role are already sitting in the note in the same place every time, the letter is a re-presentation of your own record rather than a fresh act of writing. For practices where the administrative load is really on the billing side, Supa also builds the revenue cycle for outpatient mental health practices.

The important word is reviewed.

The final letter should reflect your assessment, your professional judgment, and the requirements applicable to the patient.

What it cannot do is decide. It cannot tell you whether the patient has a disability, whether the animal is related to it, or whether your state's requirements are satisfied. Those stay with you, and the signature is where that responsibility becomes visible.

AI can draft the document.

You sign it.

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What should you check before signing an ESA letter?

Use this final review.

Clinical

• Assessment: Did I actually evaluate the request?
• Condition: Is the relevant clinical condition accurately described?
• Function: Is the functional impact supported by my record?
• Animal relationship: Is the animal's role based on information I actually assessed?
• Rationale: Can I explain why I support the recommendation?

Documentation

• Identity: Is the patient's name correct?
• Relationship: Is my professional relationship accurately described?
• Credentials: Are my license details correct?
• Date: Is the letter dated?
• Signature: Have I authenticated the document?

Scope

• Purpose: Do I know what the letter is being used for?
• Legal claims: Have I avoided promising a legal outcome?
• Service-animal status: Have I avoided confusing an ESA with a service animal?
• Animal training: Have I avoided certifying facts I cannot verify?
• Privacy: Have I included only appropriate clinical information?

State requirements

• Jurisdiction: Have I verified the applicable state requirements?
• Relationship duration: Does the state impose a minimum relationship period?
• Required fields: Have I included state-specific information?
• Required notices: Have I provided any required notices?

If any answer is no, stop before signing.

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ESA letter template: quick version

If you need a shorter starting point for a routine housing request, use this structure:

• [CLINICIAN LETTERHEAD]

Date: [DATE]

Re: [PATIENT NAME]

To Whom It May Concern:

I am [NAME], a [CREDENTIAL] licensed in [STATE/JURISDICTION], license number [NUMBER]. I am currently providing professional care to [PATIENT NAME].

Based on my clinical evaluation, [PATIENT NAME] has [RELEVANT CONDITION / CLINICAL INFORMATION], which affects [RELEVANT FUNCTIONING].

Based on my assessment, the presence of an emotional support animal is related to the patient's disability-related needs. Specifically, [PATIENT-SPECIFIC CLINICAL RATIONALE].

I recommend that [PATIENT NAME] be permitted to keep [ANIMAL / TYPE] as an accommodation related to their disability, subject to applicable law and the relevant accommodation process.

This letter reflects my clinical opinion and does not certify the animal as a service animal or certify animal training that I have not independently evaluated.

Please contact me at [CONTACT INFORMATION] if additional information is needed and may appropriately be disclosed.

Sincerely,

• [SIGNATURE]
• [NAME, CREDENTIALS]
• [LICENSE INFORMATION]
• [PRACTICE]
• [CONTACT INFORMATION]

Use the short version only when it contains everything required for your particular situation.

For a state such as California, add the required statutory information and complete the required clinical and relationship steps before issuing it.

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Frequently asked questions about ESA letter templates

Is there an official ESA letter template?

No. No federal agency publishes one, and no state requires a particular form. The Fair Housing Act asks whether there is a disability and a disability-related need for the animal; it says nothing about the shape of the clinician's letter. State statutes such as California's AB 468 add required content, not a required template.

What should an ESA letter include?

A practical letter identifies the clinician and patient, establishes the professional relationship where relevant, describes the relevant clinical basis and functional impact, explains the animal's disability-related role, states the recommended accommodation, and includes appropriate date, signature, and professional information.

Does an ESA letter need a diagnosis?

Not necessarily. The letter should contain enough clinical information to support your professional opinion while avoiding unnecessary disclosure. Include the DSM diagnosis only when it is appropriate and necessary for the purpose, and remember that a diagnosis on its own does not explain the disability-related need for an animal.

Can I use the same ESA letter template for every patient?

Use the same structural template if it helps your practice, but the clinical content should be individualized. Do not use identical clinical rationale for patients whose circumstances differ.

Does an ESA letter need letterhead, or a particular format?

No prescribed format. Letterhead makes the source of the document obvious and carries your contact information, which is why most clinicians use it, but what matters is that the letter identifies you, your credentials, the patient, the relevant clinical basis, the date and your signature. State and recipient requirements can add to that list.

Does an ESA letter need to mention the Fair Housing Act?

Not necessarily. If the letter is specifically for a housing accommodation, a focused reference to the applicable housing context can be useful, but the clinician does not need to turn the document into a legal analysis.

Does an ESA letter make an animal a service animal?

No. Under the ADA, service animals are separately defined around individually trained work or tasks. Emotional support alone does not establish ADA service-animal status.

Can an ESA letter be used for housing?

Yes, that is its main use. A housing provider may ask for reliable disability-related information when the disability and the disability-related need for the animal are not obvious, and your letter is what answers that. Since 2026, HUD itself will generally pursue a reasonable-cause finding only where the animal is individually trained, but state law and private Fair Housing Act suits are unaffected.

Does California require a specific ESA letter format?

No template, but real requirements: license information in the document, a 30-day client-provider relationship, a clinical evaluation, and a notice about the penalty for misrepresenting a dog as a service dog. Our California guide walks through each one.

Can I write an ESA letter after one session?

That depends on the jurisdiction and your clinical circumstances. California requires a client-provider relationship of at least 30 days before the practitioner provides the documentation, with an exception for individuals verified to be homeless. Most states have no equivalent waiting period, which is a reason to check rather than assume. Who can write an ESA letter covers the licensure side of the same question.

What if the patient brings me a prewritten ESA letter?

Review it as a draft. Do not sign statements that you cannot independently support or that exceed your professional role.

Can AI generate an ESA letter?

AI can generate a draft from clinician-provided information. The clinician should review the clinical content, verify the facts and applicable requirements, and make the final professional decision before signing.

What if I do not think an ESA is clinically appropriate?

Do not issue documentation that does not reflect your professional opinion. Document your assessment and discuss appropriate alternatives or next steps with the patient.

Does a housing provider have to accept any ESA letter?

A clinician's letter is part of an accommodation process. It does not automatically guarantee approval. The applicable housing law and facts of the request determine the outcome.

How often should I update my ESA letter?

There is no single universal renewal interval that applies to every clinician and every jurisdiction. Follow applicable law, professional standards, practice policy, and the requirements of the specific accommodation process.

Final ESA letter checklist

Before you sign:

• I know why the patient needs the letter.
• I have an appropriate clinical relationship with the patient.
• I have completed an appropriate clinical evaluation.
• I can support the disability-related need documented in the letter.
• I have described functional impact accurately.
• I have individualized the animal-related rationale.
• My credentials and license information are correct.
• I have checked state-specific requirements.
• I have avoided unnecessary clinical disclosure.
• I have not certified animal training I cannot verify.
• I have not represented the ESA as a service animal.
• I have not guaranteed a legal outcome.
• I have reviewed every sentence before signing.

The template saves you from rebuilding the document.

It does not replace the assessment.

For clinicians, that is the line worth protecting.

If you want the longer treatment of the clinical and legal background behind this template, start with our clinician's guide to ESA letters, then check who can write an ESA letter for the licensure and telehealth questions and California AB 468 if your patient is in California.

Sources

1. California Board of Behavioral Sciences. (2022). Law change regarding emotional support animals: What BBS licensees need to know. bbs.ca.gov

2. California Board of Psychology. Law change regarding emotional support animals: What Board of Psychology licensees need to know. psychology.ca.gov

3. California Civil Rights Department. (2026, February). Housing and reasonable accommodations for people with disabilities. calcivilrights.ca.gov

4. California Civil Rights Department. (2026, July 20). Legal alert: Compliance with state fair housing laws with regard to emotional support animals (CRD 2026-01). calcivilrights.ca.gov

5. California Civil Rights Department. (2026, August). Emotional support animals and fair housing law. calcivilrights.ca.gov

6. California Civil Rights Department. Housing. calcivilrights.ca.gov

7. California Health and Safety Code § 122318 (practitioner requirements for emotional support dog documentation). leginfo.legislature.ca.gov

8. California Health and Safety Code § 122319 (civil penalties; housing rights preserved). leginfo.legislature.ca.gov

9. California Legislature. AB 468: Emotional support animals (Stats. 2021, ch. 168). leginfo.legislature.ca.gov

10. Fair Housing Act, 42 U.S.C. § 3604(f)(3)(B). law.cornell.edu

11. Reasonable accommodations, 24 C.F.R. § 100.204. law.cornell.edu

12. U.S. Department of Health and Human Services. Minimum necessary requirement. hhs.gov

13. U.S. Department of Housing and Urban Development. (2026, April 6). Withdrawal of assistance animal guidance documents, 91 FR 17291 (Docket FR-6571-N-01). govinfo.gov

14. U.S. Department of Housing and Urban Development, Office of Fair Housing and Equal Opportunity. (2026, May 22). Enforcement guidance: Assessing requests for the use of an animal as a reasonable accommodation under the Fair Housing Act [Memorandum]. hud.gov

15. U.S. Department of Justice. ADA requirements: Service animals. ada.gov

16. U.S. Department of Justice. Frequently asked questions about service animals and the ADA. ada.gov

17. U.S. Department of Justice. Service animals. ada.gov

Clinical and legal note: This template is educational and should be adapted to the clinician's profession, jurisdiction, patient, and intended use. State requirements can differ. Clinicians should verify current requirements before issuing documentation. Every source above was opened and checked on September 25, 2026.