You can open the Emotional Support Animal Letter Template For Therapist in multiple formats, including PDF, Word, and Google Docs.
Emotional Support Animal Letter Template For Therapist Printable | Editable FormSample
Examples
[Therapist’s Name]
[Therapist’s License Number]
[Therapist’s Address]
[Therapist’s Phone]
[Therapist’s Email]
[Patient’s Name]
[Patient’s Address]
[Patient’s Phone]
[Date]
I am writing this letter to confirm that [Patient’s Name] has been under my professional care since [Start Date]. After thorough assessment, I believe that having an emotional support animal (ESA) can significantly benefit [Patient’s Name]’s mental health and well-being.
[Patient’s Name] suffers from the following condition(s): [List the diagnosed condition(s) such as anxiety, depression, PTSD, etc.]. This condition severely limits their ability to perform daily activities and impairs their overall quality of life.
Based on my clinical experience, the presence of an emotional support animal can provide comfort and support that greatly eases the symptoms faced by [Patient’s Name]. The ESA will assist in coping with their emotional and psychological limitations, facilitating a more effective treatment approach.
The emotional support animal recommended for [Patient’s Name] is as follows:
Species: [Dog/Cat/Other]
Breed: [Specify breed if applicable]
Name: [Animal’s Name]
Age: [Animal’s Age]
This letter serves as official documentation of my recommendation and is issued under the Fair Housing Act and the Air Carrier Access Act. It is essential for [Patient’s Name] to have their ESA when accessing housing and travel services.
If you have any questions or require further information, please do not hesitate to contact me at the phone number or email provided above. Thank you for your attention to this important matter.
[Signature of the Therapist]
[Therapist’s Name]
[Therapist’s Credentials]
[Therapist’s Name]
[Therapist’s License Number]
[Therapist’s Address]
[Therapist’s Phone]
[Therapist’s Email]
[Patient’s Name]
[Patient’s Address]
[Patient’s Phone]
[Date]
This letter serves to affirm that I have been treating [Patient’s Name] for [Duration of Treatment] for [Specify Condition(s)]. The inclusion of an emotional support animal is a critical part of their ongoing therapy.
[Patient’s Name] experiences significant distress due to [Briefly Explain Limitations]. This ESA will provide emotional stability and support, which are necessary for their treatment and daily functioning.
As part of their therapeutic care, I recommend that [Patient’s Name] be allowed to reside with their emotional support animal in all situations, including housing and travel. This is crucial for their emotional and psychological health.
The recommended emotional support animal is as follows:
Species: [Dog/Cat/Other]
Breed: [Specify Breed if applicable]
Name: [Animal’s Name]
Age: [Animal’s Age]
This letter complies with the guidelines set forth by the Fair Housing Act and the Air Carrier Access Act, acknowledging the rights of individuals with emotional support animals.
If any further information is needed regarding this recommendation or my qualifications to provide this letter, please reach out using the contact information listed above.
Sincerely,
[Signature of the Therapist]
[Therapist’s Name]
[Therapist’s Credentials]
Format
Please complete the form below to create the Emotional Support Animal Letter Template for Therapist. All fields must be filled out to ensure a clear and complete letter. We provide examples to guide you through each step. Emotional Support Animal Letter Template for Therapist 1. Therapist Information 2. Client Information 3. Animal Information 4. Statement of Need 5. Duration of Support 6. Benefits of the Animal 7. Confidentiality Notice 8. Therapist’s Signature and Date 9. Client Confirmation
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Emotional Support Animal Letter Template For Therapist Printable | Editable FormPrintable
