How to get an ESA letter

These letters offer extended legal protections

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Emotional support animals (ESAs) provide valuable support and comfort to patients suffering from various mental health disorders. Patients experiencing stress, anxiety, post-traumatic stress disorder (PTSD) or other issues may benefit from the presence of an ESA.

Federal and state laws protect the rights of ESA handlers, especially concerning reasonable accommodations for housing.

Key insights

ESA letters must be written by licensed mental health professionals.

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These letters can be obtained through legitimate online companies.

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Having an ESA letter can grant you legal protections with housing and your landlord.

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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: What is equal-opportunity housing?

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.

Where to get a legit ESA letter

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.

» COMPARE: Best ESA letter websites

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.

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    What should be included in a legitimate ESA letter?

    Legitimate ESA letters must be drafted on the LMHP’s letterhead and signed and dated by the LMHP. They must also include the following information:

    • LMHP name, license number, license type and contact information
    • Patient’s name
    • Confirmation of doctor-patient relationship
    • Concise assessment of the patient's ESA qualification without disclosing protected health information
    • Date of issuance and expiration
    Do all doctors provide ESA letters?

    No, not all doctors provide ESA letters. Most ESA letters are written by licensed mental health professionals. Examples include licensed therapists, counselors, psychologists, psychiatrists.

    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.

    Article sources

    ConsumerAffairs writers primarily rely on government data, industry experts and original research from other reputable publications to inform their work. Specific sources for this article include:

    1. ADA National Network, “Assistance Animals Under the Fair Housing Act, Section 504 of the Rehabilitation Act, and the Air Carriers Access Act.” Accessed March 23, 2024.
    2. U.S. Department of Housing and Urban Development, “Assessing a Person’s Request to Have an Animal as a Reasonable Accommodation Under the Fair Housing Act.” Accessed March 23, 2024.
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