What a legitimate ESA letter actually contains

What belongs on the letter

• The clinician's name, licence type, licence number, and the state that issued the licence.
• Confirmation that the clinician is licensed in the state where you live. A letter from a clinician licensed elsewhere is the single most common defect.
• A statement that you have a condition that substantially limits a major life activity, without needing to name the diagnosis.
• A statement that the animal provides disability-related support or therapeutic benefit.
• The date of issue, and an expiry or review date. Twelve months is the usual convention.
• The clinician's signature and contact details, so a housing provider can confirm the letter is genuine.

Where states impose extra requirements

Some states regulate the letter itself, separately from the accommodation. California is the strictest example. Under AB 468, in force since 1 January 2022 and codified at Health and Safety Code sections 122318 to 122320, a valid letter requires all of the following.

• The clinician holds a valid, active California licence, and the letter states the licence number, jurisdiction, and type.
• The clinician has provided services to you for at least 30 days before issuing the letter.
• The clinician has completed a clinical evaluation of your need for the animal.
• The letter states that misrepresenting an emotional support animal as a service animal is unlawful.

Warning signs

• Instant approval, or a letter issued before any clinician has looked at your assessment. A clinician who has not reviewed anything has not formed an opinion.
• No named clinician, or no licence number. A letter a housing provider cannot check is a letter a housing provider can ignore.
• A clinician licensed in a state other than yours.
• Registration, certification, or an ID card sold alongside the letter. None of these exist in law.
• A guarantee of approval. Nobody can guarantee a clinical opinion in advance, and an offer to do so says the opinion is not real.
• Claims that the letter gives you public access or lets you fly with the animal. Neither has been true since January 2021.

How a housing provider checks a letter

A housing provider is generally entitled to confirm that the clinician is real, licensed, and actually wrote the letter. Most do this by looking up the licence number in the state licensing board's public register and, if still unsure, contacting the clinician's office.

A verification reference on the letter makes this quicker and avoids anyone having to share clinical detail. On this site each issued letter carries an ESA ID that a housing provider can check without seeing any health information at all.