TherapyPaws&Claws

If you’re living with anxiety, depression, PTSD, or another mental health condition, an emotional support animal (ESA) can make a real difference in your daily life. But to get the legal protections that come with having an ESA — especially for housing — you need an ESA letter from a licensed mental health professional.

This guide walks you through exactly how to get an emotional support animal letter in 2026, what it costs, how to avoid scams, and what your rights actually are under current federal law.

What is an Emotional Support Animal Letter?

An ESA letter is a signed document from a licensed mental health professional (LMHP) — such as a psychologist, psychiatrist, licensed clinical social worker, or licensed professional counselor — that confirms two things:

1. You have a recognized mental health condition listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
2. An emotional support animal is part of your treatment plan and provides therapeutic benefit for that condition.

This letter is not a registration, certification, or ID card. Those products you see advertised online? They carry zero legal weight. The only thing landlords and housing providers are legally required to accept is a letter from a real, licensed provider.

Under the Fair Housing Act (FHA), landlords must make reasonable accommodations for tenants with ESAs — even in buildings with “no pets” policies. However, since the 2021 changes by the U.S. Department of Transportation, ESAs are no longer guaranteed access on commercial flights. Individual airlines set their own policies now.

Who Qualifies for an ESA Letter?

You don’t need to have a specific diagnosis before seeking an ESA letter. But you do need to have a legitimate mental health condition that meaningfully affects your daily life.

Mental Health Conditions That Qualify

There’s no official government list of “qualifying conditions,” but the most common ones include:

• Generalized anxiety disorder
• Major depressive disorder
• Post-traumatic stress disorder (PTSD)
• Panic disorder
• Social anxiety disorder
• Bipolar disorder
• Obsessive-compulsive disorder (OCD)
• Phobias (agoraphobia, specific phobias)
• Attention-deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorder
• Seasonal affective disorder
• Chronic stress or adjustment disorders

The key factor isn’t the specific diagnosis — it’s whether the condition substantially limits one or more major life activities, and whether an ESA provides genuine emotional relief.

Do You Need a Diagnosis?

Not necessarily before you start the process. A licensed mental health professional can evaluate you and determine if you meet the criteria during your consultation. If you’ve never spoken to a therapist before, that’s completely fine. The evaluation itself serves as your initial assessment.

That said, if you already have an existing relationship with a therapist, psychiatrist, or counselor, they’re often the best person to write your letter. They already know your history and can speak to how an ESA fits into your treatment.

Step-by-Step Process to Get an ESA Letter

Getting a legitimate ESA letter is straightforward, but there are a few steps you need to follow to make sure your letter holds up legally.

Step 1: Assess Your Need

Before anything else, be honest with yourself about why you want an ESA letter. This isn’t a workaround for pet-unfriendly housing — it’s a medical accommodation for people with real mental health conditions.

Ask yourself:

• Does my mental health condition affect my ability to function day-to-day?
• Does having an animal around genuinely reduce my symptoms?
• Am I willing to take responsibility for the animal’s behavior and care?

If you answered yes to these questions, an ESA letter may be right for you.

Step 2: Find a Licensed Mental Health Professional

Your ESA letter must come from an LMHP who is licensed in your state. This can be:

• A psychologist (PhD or PsyD)
• A psychiatrist (MD or DO)
• A licensed clinical social worker (LCSW)
• A licensed professional counselor (LPC)
• A licensed marriage and family therapist (LMFT)

If you don’t already have a therapist, you can find one through your insurance provider, Psychology Today’s therapist directory, or through a legitimate telehealth platform that specializes in ESA evaluations.

Step 3: Schedule an Evaluation

During the evaluation, the mental health professional will:

• Review your mental health history
• Discuss your current symptoms and how they affect your life
• Determine whether an ESA would provide therapeutic value
• Assess whether you can properly care for the animal

This can happen in person or via telehealth (video call). Both are legally valid in all 50 states, though some states have specific rules about telehealth evaluations for ESA letters. For example, as of 2024, states like California, Florida, and New York require a real-time interaction (not just a questionnaire) before an LMHP can issue an ESA letter.

Step 4: Receive Your Letter

If the provider determines you qualify, they’ll issue your ESA letter — usually within a few days. The letter should be on their professional letterhead and include all the required elements (more on that below).

Once you have your letter, you can present it to your landlord or property manager when requesting a reasonable accommodation for your emotional support animal.

Online vs. In-Person ESA Evaluations

Both online and in-person evaluations can produce legally valid ESA letters. The most important factor is that the evaluation involves a real conversation with a licensed professional — not just clicking through an automated form.

Legitimate Online ESA Services

Good telehealth platforms for ESA evaluations share a few traits:

• They connect you with an LMHP licensed in your state
• They require a live video or phone consultation (not just a form)
• They provide letters on the clinician’s professional letterhead
• They offer follow-up support if your landlord has questions
• They have transparent pricing with no hidden upsells

Some well-known platforms include Certapet, ESA Doctors, and Pettable. Always verify that the specific clinician assigned to you holds an active license by checking your state’s licensing board website.

Red Flags: Scam ESA Websites to Avoid

The ESA letter space is full of scams. Here’s how to spot them:

• “Instant” or “same-day” letters with no evaluation — Any site that offers a letter without a real conversation with a licensed provider is selling a worthless document.
• ESA “registration” or “certification” sites — There is no national ESA registry. These sites take your money and give you a meaningless certificate and ID card.
• No verifiable clinician information — If you can’t find the name and license number of the professional writing your letter, walk away.
• Guarantees before evaluation — No legitimate provider can promise you’ll qualify before actually assessing you.
• Pressure to buy packages — Sites pushing ESA vests, ID cards, and “registration packages” alongside the letter are prioritizing profit over patient care.

The Federal Trade Commission has also warned consumers about fraudulent pet-related schemes, including fake ESA services.

How Much Does an ESA Letter Cost?

A legitimate ESA letter typically costs between $150 and $300. Here’s what influences the price:

If a site charges less than $100 for an ESA letter and doesn’t include a proper evaluation, that’s a warning sign. On the other hand, you shouldn’t need to pay more than $300 for a single ESA letter and evaluation.

Some health insurance plans may cover the evaluation portion if it’s billed as a mental health consultation, but most won’t cover the letter itself. It’s worth calling your insurance company to ask.

How Long is an ESA Letter Valid?

Most ESA letters are valid for one year from the date of issue. After that, you’ll need a renewal — which involves a follow-up evaluation with a licensed provider.

Some important things to know about validity:

• Landlords can request updated documentation annually. Under HUD guidelines, housing providers may ask for a current letter when you renew your lease or if your original letter has expired.
• Renewal evaluations are usually shorter and cheaper than the initial assessment — often $75 to $150.
• Your letter must be current at the time you present it. An expired letter won’t hold up if a landlord challenges it.

Set a reminder on your calendar about a month before your letter expires so you have time to schedule a renewal evaluation.

What Should an ESA Letter Include?

A valid ESA letter needs to contain specific information to be accepted by housing providers. According to HUD’s 2020 guidance on assistance animals, a proper ESA letter should include:

• The provider’s name, credentials, and license number
• The provider’s contact information (phone, address, email)
• State of licensure and license type
• The date of issuance
• A statement that you have a disability-related need for the emotional support animal
• Confirmation that the animal provides disability-related therapeutic benefit
• The provider’s signature
• Must be on official letterhead

The letter does not need to disclose your specific diagnosis. Under fair housing law, you’re entitled to privacy regarding your condition. The landlord only needs to know that you have a qualifying disability and that the ESA is part of your treatment.

Frequently Asked Questions

Can my landlord deny my emotional support animal?

Under the Fair Housing Act, landlords generally cannot deny a valid ESA request. However, there are exceptions. If the animal poses a direct threat to others’ safety, causes significant property damage, or if the property qualifies for an exemption (owner-occupied buildings with four or fewer units, single-family homes rented without a broker), the landlord may legally deny the request. They also cannot charge pet deposits or pet rent for ESAs, though you can be held liable for any damage the animal causes.

What’s the difference between an emotional support animal and a service animal?

Service animals are individually trained to perform specific tasks for a person with a disability — such as guiding someone who is blind or alerting someone with epilepsy to an oncoming seizure. They’re protected under the Americans with Disabilities Act (ADA) and can go virtually anywhere in public. Emotional support animals provide comfort through companionship but aren’t trained for specific tasks. ESAs are protected primarily under the Fair Housing Act for housing purposes, but they don’t have public access rights like service dogs do.

Can any animal be an emotional support animal?

Technically, yes — there’s no species restriction in the Fair Housing Act. Dogs and cats are the most common ESAs, but people have had rabbits, birds, miniature horses, and other animals approved. That said, HUD’s 2020 guidance allows landlords to apply extra scrutiny for “unique” animals and may require additional documentation explaining why that specific type of animal is needed for your condition.

Do I need to register my emotional support animal?

No. There is no legitimate national ESA registry. Any website selling ESA registration, certification, or ID cards is not providing anything with legal standing. The only document you need is a valid ESA letter from a licensed mental health professional. Don’t waste money on registries.

Can I get an ESA letter for multiple animals?

Yes, but each animal typically needs to be individually justified in your ESA letter. Your mental health provider must explain why multiple animals are necessary for your treatment. Landlords may push back on multiple ESA requests, so having clear clinical reasoning documented in your letter is especially important in these cases.

Wrapping Up

Getting an emotional support animal letter in 2026 is a straightforward process when you work with the right provider. Find a licensed mental health professional, complete a real evaluation, and receive a properly formatted letter. That’s it.

Stay away from sites selling instant registrations or guaranteed approvals — they’re either scams or producing documents that won’t hold up when you actually need them. Your ESA letter is a medical document, and it should come from a real clinician who has actually assessed your needs.

If you’re considering an ESA and want to learn more about the different types of support animals, check out our guides on service dog breeds for anxiety and depression and therapy dogs in schools.