What Is an Emotional Support Animal Letter, Exactly?
At Santos Counseling, we approach ESA letters with years of experience and clinical understanding. I share this because it’s important to know and trust your counseling provider when you seek an ESA letter. An ESA letter, in short, is an emotional support animal letter that is provided by a licensed mental health professional.
Our counseling office has experience in the key areas that connect to effective diagnosis and documentation. This includes understanding the DSM-5 and utilizing psychometric test instruments. Our counselors approach the ESA letter by focusing on the mental health condition that you are experiencing and exploring how an emotional support animal is part of your treatment. Please know that this is not a certificate you buy. It is not a registration. There is no federal or state ESA “registry.” An ESA letter is a clinical recommendation, and the only legitimate way to obtain one is from a licensed clinician who has actually evaluated you.
With a valid ESA letter from a counselor such as one at Santos Counseling, you have specific legal protections under the federal Fair Housing Act, which requires most landlords to accommodate emotional support animals. That’s what an ESA letter is. The rest of this guide covers who can write one, how to get one, what a real one includes, how much it should cost, and how to tell the difference between a legitimate letter and one of the online scams the FTC and multiple state attorneys general have been warning about.
What an ESA Letter Actually Includes
At Santos Counseling, we often get asked the question. What does the ESA letter include? A legitimate ESA letter is typically one page on the clinician’s official letterhead and contains:
- The clinician’s name, license type, license number, and state of licensure
- The clinician’s contact information (phone and address of the counseling practice)
- The date of issue and, in most cases, an expiration date
- A statement that the client is under the clinician’s care and has a diagnosed mental health condition (the specific diagnosis is usually not disclosed to protect the client’s privacy)
- A statement that the emotional support animal is part of the treatment plan for that condition
- The clinician’s signature
Who Can Write an ESA Letter?
Under federal guidance (HUD’s 2020 guidance on assistance animals), an ESA letter must be written by a licensed health care provider who has an established relationship with the client. Before deciding to pursue an Emotional Support Animal (ESA) letter, I encourage you to thoroughly research the requirements and understand what does and does not qualify for an ESA recommendation. The information below provides a general overview of common situations that may not qualify; however, it is not an exhaustive list. Because laws, regulations, and clinical standards can change, please conduct your own research and consult with a qualified mental health professional if you have questions about your specific circumstances.
Common professionals that can provide an ESA letter:
- Licensed Clinical Mental Health Counselors (LCMHC / LCMHCS) — like the clinicians at Santos Counseling.
- Licensed Clinical Social Workers (LCSW)
- Licensed Marriage and Family Therapists (LMFT)
- Licensed Psychologists (PhD, PsyD)
- Psychiatrists and other physicians (MD, DO)
- Licensed Psychiatric Nurse Practitioners
In case you are curious, all of these have in common one key item: they are licensed by a state board, they are legally allowed to diagnose mental health conditions, and they are professionally accountable for what they write.
What does not qualify for an ESA:
- Coaches, life coaches, or health coaches
- Online forms that generate a “letter” after a 10-question quiz
- “ESA specialists” who aren’t licensed clinicians
- Any service that promises a letter without a real session
How To Get Started With An ESA Letter?
What is an ESA Letter Used For?
ESA stands for Emotional Support Animal.
Persons with emotional support animals must show that their animal provides emotional support in ways that reduces or alleviates symptoms. The symptoms can be connected to a diagnosis.
AN ESA Letter is written by a Licensed mental health professional such as a licensed professional counselor or psychologist who has training connected to writing the letter.
ESA Letters are required in certain settings. Such as on airlines or when seeking residents in apartment complex. What takes place is that a person may find their pet directly connected to their mood.
As an example, Steve has a pet cat. Steve shares that his cat helps reduce his heart rate when anxious, provide a healthy distraction when having bad thoughts, and alleviate his stress when feeling on edge.
What Can Emotional Support Animals Do?
Emotional Supportive Animals can do certain things that another pet cannot. An ESA can under the protection of the fair housing act, live with their owner. In addition to living with their owner, ESA allows pets to fly on airplanes with their owner. In both instances the owner is not charged.
Having an ESA is truly a beautiful connection. Many individuals share how an emotional support animal reduces their symptoms of worry and racing thoughts. Being able to have your pet with you while at home after a stressful day at work can work to reduce negative symptoms.
It is equally important to remember that an emotional supportive animal differs from a service dog. A service dog has training connected to the service they are providing. Such as aiding the blind. This is not to say that an ESA does not have training.
When Should A Person Seek An ESA Letter?
The first item to remember is that an ESA differs from a pet. The difference is made in the pet being an emotional support animal that can provide aid to the owner in areas connected to emotional and life challenges.
Such as a person with a diagnosis of Major Depressive Disorder, having an ESA that directly supports them by reducing stress caused by the depression or emotional disability.
If you feel that your pet is supportive then you may qualify for an ESA letter. There are certain steps that should be taken and areas that should be considered. First, one must acknowledge that seeking an ESA letter is not a guaranteed process. Seeking an ESA letter directly means that you are experiencing emotional and life challenges that highlight a certain diagnosis. Such as Generalized Anxiety Disorder or Major depressive Disorder.
The ESA letter should be a process versus a one stop shop. A process in which you are working with a licensed mental health professional that holds credibility, professionalism, and clinical competence. There are ample online options that allow a person to pay a certain amount of an ESA letter.
Personally, I am not well versed on them. As a Licensed counselor, I find that professionalism is important when seeing an ESA. Choosing to work with a Licensed mental health professional is a clear path to building a health relationship with a counselor and working towards the ESA letter.
Are You Ready For Your ESA Letter?
Contact counselors at Santos Counseling PLLC to help you with the process of ESA letters. If you are ready to get started give us a call.
When working with a Licensed mental health professional, the process can include the following:
- Building a relationship with the counselor.
- Engaging in counseling sessions that work to understand your relationship with your pet.
- Exploring your past medical history.
- Exploring a diagnosis and the symptoms connected to the diagnosis.
At the end, the counselor you choose to work with, should build a healthy relationship with you in order to conclude that the ESA Letter is appropriate.
Frequently Asked Questions About ESA Letters
Do I need a specific diagnosis to qualify for an ESA?
You need a mental health condition that is diagnosable under standard clinical criteria (DSM-5-TR) and for which the animal provides therapeutic support. Common qualifying conditions may include anxiety disorders, depression, PTSD, and adjustment disorders — but the determination is a clinical one made by your evaluating clinician, not a checklist.
How do I get an ESA letter in North Carolina?
Santos Counseling provides ESA evaluations in Greensboro and online across North Carolina — call 336-663-6570 or email admin@santoscounseling.com to schedule.
How much does an ESA letter cost?
Please contact our counseling office to learn more about the ESA fees.
Can my therapist write an ESA letter for me?
Yes, our counselors at Santos Counseling hold training and understanding of ESA letters. Many therapists write ESA letters for clients. If your current therapist doesn’t write them, please contact our counseling office to seek a separate ESA evaluation with a licensed clinician.
Does an ESA letter expire?
Yes — most housing providers require a letter dated within the past 12 months. Renewal is straightforward if you’re still in active treatment.
What does an ESA Letter NOT give you?
A valid ESA letter does NOT give you:
- Public access rights. ESAs are not service animals under the ADA. Restaurants, stores, workplaces, and most public spaces are not required to allow them.
- Automatic airline access. Since 2021, most airlines treat ESAs as pets and charge pet fees accordingly.
- Any obligation on employers. Workplace accommodation is a separate ADA process.
- A diagnosis. The letter references that a diagnosis exists; it doesn’t establish one for other purposes.
What does a ESA Letter give you?
A valid ESA letter gives you:
- Housing rights under the Fair Housing Act.
- Documentation your treating clinician can reference in your medical record
How long does an ESA letter last?
Most are valid for 12 months from the date of issue. Renewals with your existing clinician are typically quick.
Can any therapist write an ESA letter?
Any licensed mental health professional who has an established education and training may be a good fit for an ESA letter provider. one.
What are resources for ESA Letters?
Additional resources to better understand Emotional Support Animal Letters include:
