What is an ESA Letter?
An Emotional Support Animal letter is documentation from a licensed mental health provider confirming that your animal provides therapeutic benefit for a diagnosed mental health condition. Under the Fair Housing Act, landlords are required to make reasonable accommodations for ESAs -- including in no-pet housing -- when you have a legitimate letter from a qualified provider.
An ESA letter is different from service animal certification. No registration is required. The key is a real letter from a real provider who has actually assessed your mental health.
How We Handle ESA Evaluations
We take this seriously. Every ESA evaluation involves a clinical assessment of your mental health. We need to confirm you have a qualifying condition -- anxiety, depression, PTSD, or another diagnosis -- and that an emotional support animal is a reasonable part of your overall treatment.
For established patients, the process is straightforward. For new patients, the ESA evaluation happens as part of your initial psychiatric evaluation.
What to Expect
New patient evaluations are about 45-60 minutes. We ask about your mental health history, current symptoms, and how an ESA fits your care. If you qualify, the letter is typically ready within a few business days.
Insurance and Payment
Your psychiatric evaluation may be covered by insurance. The ESA letter itself carries a separate fee not covered by insurance. All costs are explained before your appointment.
Watch Out for Fakes
Online services that offer ESA letters without a real evaluation or from out-of-state providers are risky. Landlords in Wilmington and across North Carolina are increasingly aware of questionable letters. Ours come from licensed NC providers with proper clinical documentation that meets federal and state requirements.