How to Get an ESA Letter

What is an ESA letter?

Legitimate ESA letters, written by licensed mental health professionals (LMHPs), prescribe patients an animal as part of a mental health treatment plan.

“ESAs play a significant role in helping individuals who suffer from mental health disorders overcome the barriers,” said Sarah Jeffries, a mental health first aid trainer at Mental Health First Aid Course in London, England.

“Providing emotional support by being unconditionally loveable, providing companionship and relieving stress has been proven to be extremely effective at improving the emotional health and well-being of those suffering from mental health challenges.”

However, simple awareness of ESA benefits is not enough to protect the patient from housing discrimination. That’s where ESA letters come in.

ESA letters must be written by an LMHP who has evaluated the patient and determined their legitimate need for an ESA. Most often, these letters come from an LMHP with an existing doctor-patient relationship.

However, for patients lacking this relationship, ESA letter companies offer access to LMHPs online. Each company differs in its plans, policies and terms of use.

Legal protections of ESA letters

An ESA letter serves as evidence of the patient's genuine medical need for an ESA due to their mental illness or disability. The Fair Housing Act (FHA) requires housing providers to make reasonable accommodations for individuals with disabilities. This means they cannot deny a request to keep an assistance animal on the property, despite any pet restrictions.

Exceptions to the reasonable accommodation law under the FHA are rare, but they do exist. Some examples include situations where the accommodation could endanger others' health and safety or place an unreasonable financial burden on the property owner.

For example, if an ESA is a large, aggressive dog that poses a risk to others due to its behavior, the landlord may deny the accommodation request. However, if the ESA handler takes measures such as using a muzzle and leash consistently, it becomes harder for the landlord to refuse housing.

Another example is if the ESA is a miniature horse and the ESA handler requests the landlord to build a paddock in the courtyard. The request may be denied due to the excessive cost involved.

Before the 2021 changes to the Air Carrier Access Act, airlines were obligated to accommodate passengers with ESAs based on ESA letters. However, following the revisions, airlines are no longer required to accept ESAs, as they do not fall under the category of service animals.

Unlike service animals, which are trained to perform specific tasks to aid individuals with disabilities, ESAs primarily offer comfort through their presence.

» MORE: Emotional support dog vs. service dog

How do I get an ESA letter?

Generally, ESA letter companies follow the same steps to obtaining a letter:

1. Fill out a short pre-screening form. This helps an LMHP determine if you qualify for an ESA at a very basic level.
2. Choose a plan and pay. Most ESA letter companies require you to pay upfront after selecting the plan that works for you.
3. Meet with an LMHP. The assigned LMHP assists in identifying your specific mental health condition and evaluating whether an ESA could be beneficial in managing it.
4. Get approval or denial. After you meet with the LMHP, they will decide if you are eligible.
5. Receive your ESA letter or a refund. If you’re approved, most companies provide a digital copy of your letter within 24 to 72 hours. Denials usually result in a refund, though some companies deduct an administration or assessment fee.

Ways to tell an ESA letter website is legitimate

A legitimate ESA letter company publishes its terms and conditions along with its privacy policy on its website. It also:

• Provides transparent, upfront pricing and details of what’s included in the cost
• Features comprehensive and easy-to-access support from start to finish and beyond
• Complies with local and federal laws to ensure its letters are 100% legal and correct

By looking for these signs, you can determine if an ESA letter company is legitimate.

» READ MORE: Where can I take my emotional support dog?

Best way to get an ESA letter online

The best way to get an ESA letter online is through a trusted and legally compliant service like Pettable. It’s available nationwide, and connects you with licensed mental health professionals. Pettable offers a fast, transparent, and FHA-compliant process that typically takes 24 to 48 hours, sometimes even the same day.

Pettable’s process includes a live telehealth consultation with a state-licensed therapist who evaluates whether you qualify. If approved, your letter includes the provider’s license number, credentials and confirmation of your need for an emotional support animal. If you're not approved, Pettable gives a full refund. If your landlord challenges your letter, Pettable steps in to help validate it.

Pettable is especially useful if you’re in a state with strict ESA laws or don’t already have a provider. It’s one of the few ESA letter services that clearly outlines legal limitations, avoids misleading claims and ensures that every letter is backed by a proper clinical evaluation.

The average cost of ESA letters

The average cost of an ESA letter is between $99 and $250. Choosing only one letter for housing or travel is normally cheaper than getting both. Many companies offer additional items, like ID cards and vests.

Renewals often come at a discount, though some require signing up for autorenewal at the time of checkout.

Bottom line

To get an ESA letter, you’ll need to go through an LMHP who can confirm your need for an ESA. If you don’t have an existing relationship with an LMHP, you can contact an ESA letter company. These companies offer access to LMHPs online.

Be sure to confirm that the company is transparent in its pricing and plans, and that it complies with local and federal laws to ensure that your ESA letter is legit.