Home/How it works
Process
How an ESA Letter Is Written
No shortcuts and no theatre: a questionnaire, a licensed clinician, a consultation where required, and a signed letter only if the assessment supports one.
Free screening
Find Out Whether You Qualify
- 10 minutes of questions, nothing to pay
- Reviewed by a clinician licensed in your state
- Signed letter within 15 minutes of approval
- Declined? You are not charged for a letter
HIPAA-aligned · no card required
Tell Us Where You Live and What You Are Managing
Step one · about 10 minutes · $0
The intake covers three things: your state of residence, which determines who can legally write your letter; validated screening questions about anxiety, mood, sleep and daily functioning; and practical detail about your animal and your housing situation. There are no trick questions and nothing is scored against you automatically — a person reads the whole file.
You will also be asked what you need the letter for. A letter for a leasing office reads differently from one for a university residence life department, and the clinician tailors it.
We Match You to a Clinician Licensed in Your State
Step two · usually within 24 hours, and your letter is issued within 15 minutes of approval
This is the step certificate websites omit. A letter signed by a professional licensed three states away is the most common reason a property manager rejects documentation, and in several states writing it would breach that clinician's own licensing rules. We check the state board register before assigning your file.
If nobody in our network is licensed in your state for your presenting concern, we tell you rather than substituting someone unsuitable.
Meet Your Clinician by Video or Phone
Step three · about 5 minutes
A live consultation is required in some states before any documentation may be issued, and we default to offering one everywhere because it produces better letters. Expect questions about how long symptoms have lasted, what else you have tried, and specifically how the animal changes your day.
Bring your questions here. What happens if the landlord asks for more? What if you move states? Can the letter name two animals? This is the moment to ask.
Receive the Letter, or a Written Explanation
Step four · within 15 minutes of the clinician's approval
An approved letter is a signed PDF on the clinician's letterhead. It states that you are a person with a disability under the Fair Housing Act, that the animal alleviates identified symptoms, and that an accommodation is recommended. It does not disclose your diagnosis, because your landlord is not entitled to it.
If the clinician does not support a letter, you receive a plain explanation and any letter fee is refunded. You keep the screening summary either way.
Send It, and Get Help if There Is Pushback
Included for 12 months
We give you a short accommodation request letter to send alongside the clinical letter, because the request itself is a separate document that many tenants forget. If your provider asks follow-up questions, your clinician can respond to reasonable verification requests at no extra cost.
Licensed provider
The Physician Who Signs Your Letter
Steps two and three above are carried out by a licensed clinician — not an algorithm and not an offshore contractor. This is who conducts the evaluation, and how to verify the license yourself.
Licensed provider
Dr. Jonathan Chance Miller, MD
Licensed Physician · Telehealth · ESA & PSD evaluations
An evaluation should feel like a conversation, not an interrogation. My job is to understand what you are living with and document it accurately — or to tell you plainly if an assistance animal is not the right answer.
What you receive
The Document Set, Itemised.
The Clinical Letter (PDF)
Signed, dated, on letterhead, with the clinician's license type, number and issuing state, plus a verification contact line. One year of validity is the industry norm and what most housing providers expect.
A Reasonable Accommodation Request
An editable template addressed to your landlord that formally makes the request and cites the statute. Sending the clinical letter with no covering request is a frequent cause of delay.
A Verification Page for Your Landlord
A one-page explanation of what they may and may not ask for under HUD guidance. It saves an enormous amount of back-and-forth with leasing offices that have never processed one.
Your Screening Summary
Yours to keep and to share with your own treating provider if you have one. Stored encrypted, released only to you.
HUD notice FHEO-2020-01
HUD's guidance tells housing providers that documentation from a licensed health care professional is reliable when the professional has personal knowledge of the individual. It also warns them to be sceptical of documentation bought from websites that issue it without any clinical contact. That distinction is the entire reason our process looks slower than a $39 certificate mill.
Honest limits
Four Things This Process Cannot Do for You.
Guarantee an Approval
A clinician who has already promised the outcome is not assessing anything. Roughly speaking, a meaningful minority of applicants are declined, and that is what makes the approvals worth something.
Force a Landlord's Hand Overnight
Housing providers are allowed a reasonable period to review a request and may seek verification. If you are already facing eviction, talk to a local tenants' rights organization in parallel.
Take Your Animal on a Flight
Since January 2021 airlines may treat emotional support animals as pets. If you need to fly, read our page on psychiatric service dogs instead.
Replace Treatment
A letter is documentation, not care. If the screening surfaces something that deserves ongoing attention, your clinician will tell you so.
Related Reading
Questions
Frequently Asked Questions
The questions asked most often about this topic.
How Long Does the Whole Process Take?
The questionnaire takes about ten minutes, clinician review usually happens within 24 hours, and an approved letter arrives as a signed PDF within 15 minutes of the clinician's approval. California is the exception, where state law requires a 30-day clinical relationship first.
Do I Have to Speak to the Clinician?
Some states require a live consultation before documentation may be issued, and we offer one everywhere because it produces better letters. It runs about 5 minutes by video or phone, at a time you choose.
What Happens Immediately After I Submit the Questionnaire?
Your file is matched to a clinician licensed in your state, and we verify that license against the state board register before it is assigned. You are told who has your file and what happens next.
Can I Start the Screening and Finish Later?
Yes. Your answers are encrypted whether you finish or not, and you can return to complete them. Incomplete screenings are deleted after twelve months.
Is Anything Charged During the Screening?
No. The questionnaire and the clinician's review cost nothing. A fee applies only once a letter has been issued, and if you are declined the letter fee is refunded in full.
What if the Clinician Needs More Information?
They will ask, either through the secure portal or during the consultation. Answering promptly is the single biggest factor in how fast your letter arrives.
Who Reads My Answers?
The clinician assessing you, and the small support team who need access to run your case. Access is role-based and every record view is logged.
What Exactly Arrives in My Inbox?
The signed clinical letter as a PDF, an editable accommodation request template addressed to your landlord, a one-page explainer for your leasing office, and your screening summary.
Can the Letter Be Addressed to My Specific Landlord?
Yes. Tell us the property manager or management company at intake and the clinician can address it directly, which tends to move faster than a generic 'to whom it may concern'.
What if I Need the Letter Urgently?
Say so at intake. We cannot compress a state-mandated waiting period, and no honest provider can promise a same-day letter in a 30-day state, but we will prioritise review where the timeline is genuinely tight.
Can I Get a Letter for Two Animals in One Screening?
Yes, if the clinician's assessment supports both. Each animal has to be justified on its own terms, and requests for several animals attract more scrutiny from housing providers.
What Happens if the Assessment Is Declined?
You are told plainly why, you keep your screening summary, and the letter fee is refunded in full. If what you described deserves ongoing care rather than paperwork, the clinician will say so.
Ready to Start? The First Step Costs Nothing
Answer the questionnaire today and a clinician licensed in your state will review your file, usually within 24 hours.