What is an ESA Letter?
An Emotional Support Animal letter is a document from a licensed mental health provider that says 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 you have proper documentation from a qualified provider.
ESA letters are 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 evaluated you.
How We Handle ESA Evaluations
We do not hand out ESA letters without a real evaluation. We are a licensed psychiatric practice, and every ESA evaluation involves a clinical assessment of your mental health. We need to determine that you have a qualifying condition -- such as anxiety, depression, PTSD, or another disorder -- and that an emotional support animal is part of a reasonable treatment plan.
If you already have an established diagnosis and treatment history, the process is straightforward. If you are a new patient, your ESA evaluation happens as part of your initial psychiatric evaluation.
What to Expect
The evaluation takes about 45-60 minutes for new patients. We will ask about your mental health history, current symptoms, and how an ESA fits into your overall 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 will explain all costs upfront before your appointment.
Red Flags to Watch For
If someone offers you an ESA letter online without a real evaluation, without asking about your mental health, or from a provider who is not licensed in North Carolina -- that letter may not hold up. Landlords are getting smarter about spotting fake documentation. Our letters come from licensed providers, include proper clinical documentation, and meet all federal and state requirements.