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  • Writer's pictureRebecca Stone, LMHC

Obtaining a prescription for an emotional support animal (ESA)

Updated: Oct 26, 2022

*Note: Since the original publish date, the Air Carrier Access Act has had a Final Rule (Dec. 2020) which no longer requires airlines to permit/accommodate Emotional Support Animals as reasonable accommodations for air travel and also institutes certain paperwork requirements for flying with trained Service Animals (dogs) as well as other requirements.

I recently responded to an inquiry on Quora, "How do I find a doctor who will prescribe an emotional support animal (ESA)?" Below is my response.

As a licensed mental health counselor who has extensively researched this, written and presented on the topic, and provided these assessments and letters, I’d like to share some very important information about your question. Some of the existing responses are incomplete or incorrect.

Many people mistake or misuse references to their animals, and they may also not understand the legal rights of the different classifications of animals. For an overview of the differences of service, therapy, and support animals, read my magazine column “Service and Therapy and Support Animals, Oh My!” here: You can also find more detailed information in my blog post at:

Legally, Emotional Support Animals (ESAs) only have special rights to be in your primary residence (where you live) and possibly travel with you on airplanes, provided the animal and destination meet requirements. ESAs are also permitted in other places that are considered “pet friendly,” such as some restaurant patios who choose to allow that. If you are looking to have the animal go with you elsewhere, that is unlikely to happen unless you seek a service animal (if that’s the case, the rest of this response does not apply and a different response will be needed).

Registries and such you find listed at the top of search results will do you little good. There is no centralized registry for emotional support animals. Registries are voluntary/elective and don’t really do you any good.

You may find some websites that say they’ll send you a letter for your animal to become classified as an ESA if you pay them a fee. In many cases, those who would request the ESA letter (e.g., airline, landlord) have recognized the number of letters they receive from these companies and surmised that they’re illegitimate since they do not show you are under any sort of mental health care or treatment plan. Additionally, many people have a misconception about the rights of ESAs and have gone the route of the online letter just to have their animal classified as an ESA when they may not have a diagnosed mental health disability; this undermines the purpose of ESAs for people with legitimate mental health needs. I highly discourage you from going that route.

For a legitimate letter, you’ll need documentation of the following (at minimum) from a licensed mental health provider (e.g., licensed counselor, licensed social worker, psychologist, psychiatrist):

  • A diagnosed mental health condition;

  • A description of the treatment you have received for that condition and your response to treatment (i.e., if it helpful);

  • Treatment dates;

  • A description of how the Emotional Support Animal will support you in alleviating or reducing your symptoms or allowing you to better function on a daily basis; and

  • An evaluation on your fitness to be able to provide appropriate care for the animal.

It is my policy that I will not provide letters for clients unless I have had at least 3 appointments with them, or who can provide me with records from prior mental health treatment. The reason for this are:

  • I want to uphold the purpose of ESAs and not freely hand letters out to just anyone (and, believe me, I have had people I’ve never met before knock on the door and ask for a letter!);

  • I want the recipient of the letter to see that you have had legitimate evaluation, diagnosis, and have begun/continued treatment for your mental health condition; and

  • In reality, an ESA alone is not going to resolve your mental health concerns. The animal will only help alleviate some of the symptoms or provide general comfort. In order to truly feel better or have sustainable progress toward better mental health, you need to participate in treatment with a mental health provider.

Ready to talk about an ESA? Visit to learn more!


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