What is an ESA Letter?
An Emotional Support Animal letter is a document from a licensed mental health provider stating that your animal provides therapeutic benefit for a diagnosed mental health condition. Under the Fair Housing Act, landlords must make reasonable accommodations for ESAs -- even in no-pet housing -- as long as the documentation comes from a qualified provider who has evaluated you.
An ESA letter is not the same as service animal certification. You do not need to register your animal anywhere. What you need is a legitimate letter from a licensed provider who has actually assessed your mental health.
How We Handle ESA Evaluations
We do not hand out letters without a real evaluation. Every ESA request involves a clinical assessment. We need to confirm that you have a qualifying condition -- such as anxiety, depression, PTSD, or another disorder -- and that an emotional support animal is a reasonable part of your treatment plan.
If you already have an established diagnosis and treatment history, the process is straightforward. If you are a new patient, the ESA evaluation happens as part of your initial psychiatric evaluation.
What to Expect
New patient evaluations take about 45-60 minutes. We ask about your mental health history, current symptoms, and how an ESA fits into your care. If you qualify, we can typically provide your letter within a few business days of your appointment.
Insurance and Payment
The psychiatric evaluation portion may be covered by your insurance plan. The ESA letter itself is not covered by insurance and has a separate fee. We explain all costs upfront before your appointment.
Red Flags to Watch For
If a website offers you an ESA letter without a real evaluation, without asking about your mental health, or from a provider not licensed in North Carolina -- that letter may not hold up. Landlords are getting better at spotting questionable documentation. Our letters come from licensed providers, include proper clinical documentation, and meet all federal and state requirements.