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A Comprehensive Guide to Asking Your Doctor for an Emotional Support Animal (ESA) Letter

April 25, 2022 10 min read

Last updated: January 2026

Understanding the Importance of an ESA Letter and Housing Accommodation Rights (2026 Edition)

If you’re considering an emotional support animal (ESA) as part of your mental health support, obtaining a valid ESA letter is one of the most important steps you can take to protect your housing rights. An ESA letter is not simply a recommendation — it is the documentation housing providers rely on to evaluate reasonable accommodation requests under federal law.

In this updated 2026 guide, we explain why ESA letters matter, how housing protections actually work, and how to ask a doctor or licensed clinician for an ESA letter in a way that is respectful, effective, and compliant with current housing standards.


📘 Jump To: ESA Letters & Housing Rights (2026)


Why an ESA Letter Matters for Housing

Emotional support animals can provide comfort, grounding, and emotional stability for individuals managing mental health conditions such as anxiety, depression, PTSD, or other qualifying disabilities. However, housing protections for ESAs are not automatic — they are tied directly to proper documentation.

A valid ESA letter allows a housing provider to understand:

  • That you have a disability as defined under housing law
  • That your emotional support animal is part of your disability-related need
  • That your request qualifies as a reasonable accommodation

Without appropriate documentation, landlords are not required to modify pet policies, waive pet fees, or approve an accommodation request.


The Fair Housing Act and ESA Protections

The Fair Housing Act (FHA) is the primary federal law protecting individuals with disabilities from housing discrimination. Under the FHA, housing providers must make reasonable accommodations when a person has a disability-related need — including allowing emotional support animals in housing that otherwise restricts pets.

Important points to understand:

  • Emotional support animals are not pets under housing law
  • “No-pet” policies do not override valid ESA accommodations
  • Pet rent, deposits, and pet fees must be waived for approved ESAs
  • Breed, size, and weight restrictions do not apply

To evaluate these requests, housing providers may request reliable documentation from a licensed healthcare professional — most commonly in the form of an ESA letter.


Who Can Write an ESA Letter

An ESA letter must be written by a licensed healthcare professional who is qualified to assess mental or emotional health conditions. This may include:

  • Physicians
  • Psychologists
  • Therapists or counselors
  • Licensed clinical social workers
  • Nurse practitioners

The clinician must determine, through a legitimate clinical evaluation, that you have a disability and that an emotional support animal helps alleviate one or more symptoms related to that disability.


How to Start the Conversation with Your Doctor or Clinician

Asking for an ESA letter can feel uncomfortable, especially if you’re unsure how your provider will respond. The most effective approach is professional, transparent, and prepared.

Step 1: Prepare Before the Appointment

Before meeting with your provider:

  • Reflect on how your mental health affects daily functioning
  • Identify specific symptoms that interfere with housing stability or daily life
  • Consider how an emotional support animal helps regulate or alleviate those symptoms
  • Understand that ESA letters are for housing accommodations, not public access or travel

Preparation helps keep the conversation focused and grounded in clinical need.


Step 2: Schedule a Dedicated Appointment

Request an appointment specifically to discuss your mental health and treatment needs. This allows your provider enough time to evaluate your situation rather than addressing it briefly during a routine visit.


Step 3: Communicate Your Need Clearly

During the appointment:

  • Explain how your condition impacts your daily life
  • Describe symptoms or limitations you experience
  • Share how your emotional support animal helps reduce, manage, or stabilize those symptoms
  • Focus on function and support rather than outcomes or guarantees

Clarity and honesty are more effective than trying to persuade or pressure a provider.


Step 4: Be Open to Questions or Concerns

Some clinicians may ask questions about ESA letters, particularly due to increased scrutiny in recent years. Be prepared to:

  • Clarify that ESA letters apply to housing only
  • Acknowledge the responsibility involved in caring for an animal
  • Demonstrate understanding of appropriate use and legal limitations

A collaborative approach builds trust and credibility.


Information That May Help Your Clinician

While clinicians decide what documentation is appropriate, providing relevant context can help them understand your needs more fully.

This may include:

  • Mental health history or diagnoses (if applicable)
  • Current symptoms and functional limitations
  • Previous or ongoing treatments such as therapy or medication
  • How your emotional support animal contributes to emotional regulation, routine, or stability

The goal is not exhaustive documentation — but a clear clinical picture.


Tips for Effective Communication

  • Be honest: Share real experiences rather than generalized statements
  • Stay focused: Keep the discussion centered on housing-related needs
  • Listen actively: Address concerns respectfully and thoughtfully
  • Remain understanding: Not all providers choose to write ESA letters

If a clinician determines an ESA letter is not clinically appropriate, that decision should be respected.


What If Your Doctor Cannot or Will Not Write the Letter?

Some clinicians choose not to write ESA letters due to:

  • Scope-of-practice limitations
  • Employer or institutional policies
  • Lack of familiarity with housing documentation requirements

This does not mean you are unqualified. It simply means you may need to seek an evaluation from another licensed professional who provides ESA assessments.

Many individuals are referred for ESA evaluations by:

  • Primary care providers
  • Veterans Affairs clinicians
  • Kaiser and other large healthcare systems

If your doctor or clinician is unable to write the letter, NSAR can you help by connecting you with a clinician licensed in your state that is willing to write a valid ESA letter today.


FAQ: ESA Letters & Housing Rights (HUD-Cited)

What does HUD consider an emotional support animal?

According to Housing and Urban Development FHEO-2020-01, emotional support animals fall under HUD’s broader definition of “assistance animals.” HUD explains that assistance animals are not pets and may include animals that provide therapeutic emotional support to individuals with disabilities, even if the animals are not trained to perform specific tasks .


Does HUD require landlords to allow emotional support animals?

HUD explains in FHEO-2020-01 that under the Fair Housing Act, housing providers must consider reasonable accommodation requests for assistance animals when a person has a disability-related need. This includes emotional support animals in housing with no-pet policies, as long as the request meets FHA standards.


Can a landlord ask for documentation for an emotional support animal?

Yes. HUD clarifies in FHEO-2020-01 that when a disability or the disability-related need for an emotional support animal is not readily apparent, housing providers may request reliable documentation (an ESA Letter) confirming both the disability and the disability-related need for the animal. HUD also makes clear that landlords may not request a diagnosis, medical records, or detailed treatment information.


Does HUD allow ESA letters obtained through telehealth?

Yes. HUD explains in FHEO-2020-01 that documentation is not unreliable simply because it is obtained online. HUD recognizes that licensed healthcare professionals may provide legitimate evaluations and documentation — including through telehealth services — provided the professional has personal knowledge of the individual and is acting within their licensed scope of practice.


Are online ESA registrations or certificates recognized by HUD?

HUD states in FHEO-2020-01 that certificates, registrations, or licenses sold online do not, by themselves, establish that a person has a disability or a disability-related need for an emotional support animal. Housing providers are not required to rely on these documents alone HUDAsstAnimalNC1-28-2020.

However, HUD also clarifies that legitimate ESA letters issued by licensed clinicians — including through telehealth-based private practices — may qualify as reliable documentation, as long as the clinician has a professional relationship with the individual and conducts a proper evaluation.


Do I have to have a telephonic, video, or in-person evaluation to be considered valid?

According to Housing and Urban Development (HUD) FHEO-2020-01, HUD does not require that an emotional support animal evaluation be conducted in a specific format, such as exclusively in person, by video, or by telephone. Instead, HUD focuses on whether the documentation comes from a licensed healthcare professional who has personal knowledge of the individual and is acting within their scope of practice.

HUD explains that documentation is not unreliable simply because it is obtained online, and that licensed healthcare professionals may provide legitimate evaluations and documentation through telehealth or other remote methods (including online health assessments), as long as the evaluation reflects a real clinical relationship and professional judgment.

In other words, HUD does not mandate a specific evaluation method. What matters is that the ESA letter is based on a legitimate clinical assessment conducted by a licensed professional with sufficient personal knowledge of the individual — regardless of whether the evaluation occurs in person, by phone, or via video, or through a test battery/assessment.


Can a landlord charge pet rent or pet deposits for an emotional support animal?

No. HUD explains in FHEO-2020-01 that housing providers may not charge pet fees, pet rent, or pet deposits for assistance animals, including emotional support animals. Tenants may still be held responsible for actual damage caused by the animal, consistent with how property damage is handled for all tenants.


Can a landlord deny an emotional support animal based on breed or size?

HUD clarifies in FHEO-2020-01 that breed, size, or weight restrictions do not apply to assistance animals in the same way they apply to pets. A housing provider may only deny a request if the specific animal poses a direct threat to health or safety or would cause substantial physical damage that cannot be mitigated.


Can a landlord deny an ESA request without reviewing documentation?

HUD encourages housing providers in FHEO-2020-01 to engage in an interactive process when evaluating accommodation requests. A housing provider should not deny a request without first giving the individual a reasonable opportunity to provide reliable documentation when required.


What information should a valid ESA letter include under HUD guidance?

HUD explains in FHEO-2020-01 that documentation from a healthcare professional should generally confirm:

  • The individual has a physical or mental impairment that substantially limits a major life activity
  • The animal provides assistance or therapeutic emotional support related to that disability
  • The healthcare professional has a professional relationship with the individual

HUD does not require specific forms, notarization, or disclosure of diagnosis.


What should I do if my ESA accommodation request is denied?

HUD notes in FHEO-2020-01 that individuals who believe their accommodation request has been improperly denied may continue the interactive process, request clarification, or file a fair housing complaint. HUD identifies denials of assistance animal accommodations as one of the most common sources of fair housing complaints.

File a complaint


Final Thoughts

A valid ESA letter can play a meaningful role in protecting housing stability and supporting mental health. The process begins with open communication, proper evaluation, and accurate documentation — not shortcuts or generic certifications.

By understanding your rights, preparing for the conversation, and working with licensed professionals, you can advocate for yourself in a way that is respectful, lawful, and effective.

If your current doctor or clinician is unable to write an ESA letter, we can help connect you with a licensed provider for a proper clinical evaluation.

Your well-being matters — and having the right support at home can make all the difference.

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