You can open the ESA Letter Template For Housing in multiple formats, including PDF, Word, and Google Docs.
ESA Letter Template For Housing Printable | Editable FormSample
Examples
[Name of the Mental Health Professional]
[License Number]
[Professional’s Address]
[Professional’s Phone]
[Professional’s Email]
[Name of the Individual Requesting ESA]
[Individual’s Address]
This document serves as an official letter from a licensed mental health professional certifying that the individual named above requires an Emotional Support Animal (ESA) for their mental health and well-being.
I confirm that I have conducted an assessment of [Name of the Individual] and identify that they suffer from [Specify Mental Health Condition] which significantly limits their daily functioning.
The presence of an Emotional Support Animal is crucial for the individual’s well-being and provides necessary emotional support to help alleviate the symptoms of their condition.
The recommended ESA is [Type of Animal] with the following characteristics: [Describe the animal, including breed, age, etc.].
I recommend that [Name of the Individual] be allowed to have their ESA in housing facilities as per the Fair Housing Act, which allows individuals with disabilities to have their emotional support animals with them regardless of pet policies.
For any further questions or clarifications, please contact me at the provided details above.
[Signature of the Mental Health Professional]
[Name of the Mental Health Professional]
[Professional’s License Type]
[Name of the Licensed Therapist]
[License Number]
[Therapist’s Address]
[Therapist’s Phone]
[Therapist’s Email]
[Name of the Individual Requesting ESA]
[Individual’s Address]
This letter certifies that [Name of the Individual] has been under my care and is diagnosed with [Specify Mental Health Condition], which affects their ability to perform daily activities and requires the support of an Emotional Support Animal.
The specified mental health condition is recognized according to the DSM-5, and I have determined that the emotional support from an animal is a keystone in the individual’s therapeutic process.
The ESA provides companionship and serves a critical role in alleviating the symptoms associated with [specify conditions], which has been observed in therapy sessions.
In accordance with the Fair Housing Act, I assert that [Name of the Individual] has the right to have their ESA reside with them, even in no-pet housing situations.
The recommended ESA is a [Type of Animal] that will assist in providing the necessary emotional support for [Name of the Individual]. The animal’s presence is vital to their ongoing treatment.
Please feel free to reach out via the contact information provided above should you require additional information or clarification regarding this matter.
[Signature of the Licensed Therapist]
[Name of the Licensed Therapist]
[License Type]
Format
Please complete the form below to create the ESA (Emotional Support Animal) Letter Template for Housing. All fields must be filled out to ensure your letter meets the necessary requirements for housing accommodations. We provide examples to guide you through each step. ESA Letter Template for Housing 1. Owner Information 2. Animal Information 3. Housing Provider Information 4. Mental Health Professional’s Information 5. Reason for ESA 6. Confirmation and Recommendations 7. Signature and Date 8. Owner’s Declaration 9. Acknowledgment of Responsibilities
PDF
WORD
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ESA Letter Template For Housing Printable | Editable FormPrintable
