Emotional Support Animal Housing Prescription Letter (Sample)

Emotional Support Animals - Dogs and Cats

​Emotional Support Animal Sample Letter 

Date: (Valid for 1 year from the date issued)

To Whom It May Concern:

  Patient is under my care and I am currently treating him for a psychological disability recognized by the DSM IV-TR. I have diagnosed him with Disorder and DSM IV Code. His disability substantially limits at least one major life activity.

  It is my professional opinion the presence a emotional support animal is necessary to treat and alleviate Patient’s disorder. I have prescribed Patient to obtain a dog or a cat to serve as an emotional support animal as the primary treatment to address
his disability.

  Please allow Patient to be accompanied by his emotional support animal in the cabin of the aircraft, in accordance with the Air Carrier Access Act (49 U.S.C. 41705 and 14 C.F.R. 382).

Health Professionals License #
Date LPC License Issued:​

If you already have a doctor and are being treated for a stress related ailment you can use one of the free templates on this page to have your doctor sign which will allow you to live or fly with your pet for no additional fees.


However if you currently do not have a doctor but feel you may benefit from an Emotional Support Animal please visit our homepage for more information about the therapy services we provide.



Date: (Valid for one year from the date issued)
To Whom It May Concern:

  Patient is under my care and I am currently treating her for a mental health disability recognized in the DSM IV-TR. I have diagnosed her with Disorder and DSM IV Code Her disorder substantially limits at least one major life activity.

  As the primary treatment to address her psych- ological disability, I have prescribed Patient to obtain a dog or a cat to serve as an emotional support animal. It is my professional opinion that the presence of this animal is a necessary
treatment for the mental health of Patient because its presence will mitigate the symptoms she is currently experiencing.

  Patient meets the definition of disability under the Americans with Disabilities Act, the Fair Housing Act, and the Rehabilitation Act of 1973. Due to mental illness, Patient has certain limitations regarding [social interaction/coping with
stress/anxiety, etc.]. In order to help alleviate these difficulties, and to enhance her ability to live independently and to fully use and enjoy the dwelling unit you own and/or administer, I am
prescribing an emotional support animal that will assist Patient in coping with her disability.


Health Professional's License #
Date LPC License Issued:​

​Emotional Support Animal ​​Airline Prescription Letter (Sample)