You can open the Esa Letter For Dog Template in multiple formats, including PDF, Word, and Google Docs.
ESA Letter For Dog Template Printable | Editable FormSample
Examples
[Name of the Licensed Mental Health Professional]
[Professional’s License Number]
[Professional’s Address]
[Professional’s Phone]
[Professional’s Email]
[Name of the Client]
[Client’s Address]
[Client’s Phone]
[Client’s Email]
Emotional Support Animal (ESA) Letter for [Pet’s Name, Breed]
This letter serves to certify that [Client’s Name] is a patient under my care and has been diagnosed with [Specify mental or emotional condition]. As part of their treatment plan, I recommend the presence of an emotional support animal, specifically a dog named [Pet’s Name], to help alleviate symptoms associated with their condition.
The emotional support animal provides [Detail the specific benefits of having the animal, e.g., companionship, anxiety reduction, etc.], which plays a significant role in the client’s emotional and psychological stability.
Under the Fair Housing Act and the Air Carrier Access Act, [Client’s Name] is entitled to reasonable accommodations regarding their emotional support animal in housing settings and during travel.
The emotional support animal, [Pet’s Name], is a [Breed] weighing approximately [Weight] and is [Age] years old. This animal is not considered a pet but is an integral part of [Client’s Name]’s mental health treatment.
I, [Professional’s Name], am a licensed mental health professional in good standing. I confirm that the client’s need for an emotional support animal is medically necessary for their mental health improvement.
This ESA letter is valid for one year from the date of issuance. A renewal may be necessary depending on the client’s ongoing needs and condition stability.
[Signature of the Professional]
[Name of the Professional]
[License Type and Number]
[Name of the Licensed Mental Health Professional]
[Professional’s License Number]
[Professional’s Address]
[Professional’s Phone]
[Professional’s Email]
[Name of the Client]
[Client’s Address]
[Client’s Phone]
[Client’s Email]
Emotional Support Animal (ESA) Letter for [Pet’s Name, Breed]
An emotional support animal is defined as a companion that helps alleviate the symptoms of a person’s condition. [Client’s Name] requires [Pet’s Name] as their ESA, which plays a crucial role in their daily functioning.
I am writing to confirm that [Client’s Name] has been under my care since [Start Date] and has been diagnosed with [Specify diagnosis]. The presence of [Pet’s Name] is recommended as an essential element of their treatment.
According to federal law, [Client’s Name] carries the right to keep their emotional support animal in residential communities and travel with the animal on airlines, with proper documentation.
[Pet’s Name], a [Breed], has the following characteristics: [Include weight, age, temperament, etc.]. This animal provides significant therapeutic benefits to [Client’s Name].
As a licensed professional, I assert that the emotional support provided by [Pet’s Name] is vital for the mental health of [Client’s Name] and is medically justified.
This letter will remain effective for one year and may be renewed upon assessment of the client’s emotional health and symptoms.
[Signature of the Professional]
[Name of the Professional]
[License Type and Number]
Format
Please complete the form below to create the Emotional Support Animal (ESA) Letter for Dog Template. 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 (ESA) Letter for Dog Template 1. Patient Information 2. Mental Health Professional Information 3. Dog Information 4. Patient’s Condition 5. Need for Emotional Support Dog 6. Recommendations 7. Validation of Need 8. Signatures and Acceptance 9. Declaration and Signatures
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ESA Letter For Dog Template Printable | Editable FormPrintable
