What Is an ESA Letter?
An emotional support animal (ESA) letter is a clinical document from a licensed mental health provider confirming that you have a diagnosed psychiatric condition and that an emotional support animal serves a therapeutic role in your treatment plan. Under the Fair Housing Act, this letter entitles you to keep your ESA in housing with pet restrictions without additional deposits or fees.
An ESA letter is not a formality. It is a clinical recommendation based on a legitimate evaluation. We do not issue letters without establishing a diagnosis and treatment relationship first.
How the Evaluation Works
A full psychiatric evaluation is required before any ESA determination. During that evaluation, we assess your symptoms, diagnosis, and treatment plan. If the clinical evidence supports an emotional support animal as part of your care, we issue the letter. If it does not, we discuss alternative treatment approaches.
This distinction matters. Landlords and housing authorities in Boulder County are increasingly scrutinizing ESA documentation. A letter from a provider who has conducted a real evaluation holds up to that scrutiny. Letters from online services that skip the evaluation often do not.
What to Expect
The ESA component is integrated into your psychiatric care -- not a standalone transaction. Once your evaluation is complete and a qualifying condition is documented, the letter is typically available within a few business days. It is valid for one year and can be renewed during follow-up appointments.
Insurance and Payment
The psychiatric evaluation is covered by most insurance plans. The ESA letter may carry a separate fee. We accept Anthem Blue Cross, Aetna, Cigna, UnitedHealthcare, and Health First Colorado (Medicaid). Cash pay is also available.
Who Qualifies
Patients with a diagnosed psychiatric condition -- anxiety, depression, PTSD, or another qualifying diagnosis -- may qualify if the provider determines that an emotional support animal offers meaningful clinical benefit. The type of animal is not restricted. What matters is the documented relationship between your condition and the animal's role in your treatment.