esacard

Free template + sample

Free ESA Letter Template and Sample Letter

An ESA letter is a one-page letter from a licensed healthcare provider, on their letterhead, saying you have a disability and that your animal helps with it. Fill in your part below, take the draft to your provider as a Word file or a PDF, and they complete and sign it.

  • No sign-up
  • Word and PDF
  • State rules built in
Fill in the template
  1. 1Fill in your part

    Your name, your animal and how it helps, your state and the dates.

  2. 2Bring the draft to your provider

    Your licensed provider reviews it, edits it and signs it after their own evaluation.

  3. 3They add their details

    Name, license and contact details go in the bracketed gaps, on their letterhead.

  4. 4Give it to your landlord

    With your request to keep the animal, and keep a copy.

Free template

Fill in the ESA letter template

Fill in your part and the draft updates as you type. Your provider's details stay as bracketed gaps for them to complete.

You and your animal

Your animal

Your state and dates

Landlords usually look for a letter dated within the last year.

Your draft

[Provider name], [credentials]

[License type] · License #[number] · [State of license]

[Practice address and phone]

[Date]

Re: Reasonable Accommodation Request for an Emotional Support Animal

To Whom It May Concern:

I am a licensed mental health professional in the State of [state] ([license type], license #[number]). [client name] has been my client since [date of first appointment], and I have completed a clinical evaluation of them. They are a person with a disability as defined by the Fair Housing Act, meaning a mental health condition that substantially limits one or more major life activities.

In my professional judgment, my client's animal companion provides emotional support that alleviates one or more identified symptoms of this condition. I therefore support their request for a reasonable accommodation to keep this animal in their residence, consistent with the Fair Housing Act (42 U.S.C. § 3604(f)(3)(B)).

Please contact my office should you require verification of this letter's authenticity.

Sincerely,

[Signature]

[Provider name], [credentials] · License #[number]

Download the draft for your provider

Their part is in [brackets]; the Word file marks it in yellow.

From ESA Card

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Sample letter

What a finished ESA letter looks like

Four parts do the work. Use them to check any letter you are handed, ours to fill in or one you pay for.

Jordan R. Ellis, LCSW

Licensed Clinical Social Worker · License #SAMPLE-00000
Verified at your state licensing board · (512) 555-0100

July 22, 2026

Re: Reasonable Accommodation Request for an Emotional Support Animal

To Whom It May Concern:

I am a licensed mental health professional in the State of Texas. I have completed a clinical evaluation of my client, who is a person with a disability as defined by the Fair Housing Act, meaning a mental health condition that substantially limits one or more major life activities.

In my professional judgment, my client's animal companion provides emotional support that alleviates one or more identified symptoms of this condition. I therefore support their request for a reasonable accommodation to keep this animal in their residence, consistent with the Fair Housing Act, 42 U.S.C. § 3604(f)(3)(B).

Please contact my office should you require verification of this letter's authenticity.

Sincerely,

Jordan R. Ellis

Jordan R. Ellis, LCSW · #SAMPLE-00000

① Letterhead + credentials

Real name, real license type, real contact info. It's the first thing a leasing office looks for.

② License number

Verifiable against the state board in about 30 seconds. This is the letter's spine.

③ The clinical statement

Disability + support relationship, stated plainly, with no diagnosis disclosed. Privacy is built into the standard.

④ Date + signature

Current (within ~12 months) and personally signed. Undated PDFs get bounced.

What a landlord can check

Not the wording. A leasing office checks that the provider is real, licensed where you live, and the one who signed.

  • The license number

    Looked up on the state licensing board's site, usually in under a minute.

  • The license type

    One that can diagnose and treat mental health conditions.

  • The state

    The provider is licensed in the state where you live.

  • The date and signature

    Signed by hand or e-signature, and usually dated within the last year.

  • The office

    A real address and a phone number that answers.

What a landlord can't ask for

  • Your diagnosis or the details of your treatment
  • Your medical records

A letter you sign yourself fails the first check on the list, which is why the template leaves the signature to your provider.

Holding a finished letter? Paste it into our free ESA letter checker to see what it's missing.

State rules

Five states ask the letter for more

Pick one of these states in the template and it adds the lines that state's law asks for.

California

30 days firstDogs

For a dog, the provider must be licensed in California and have a client relationship of at least 30 days, and the letter gives the license type, number, state and effective date.

Cal. Health & Safety Code § 122318 · California guide

Arkansas

30 days firstDogs

For a dog, the provider must be licensed in Arkansas, have a client relationship of at least 30 days and evaluate you once a year, and the letter gives the license type, number, state and effective date.

Ark. Code § 20-14-1003 · Arkansas guide

Louisiana

30 days firstAny animal

For any animal, a therapeutic relationship of at least 30 days and at least two sessions, in person or remote, before the letter, which gives its own effective date and the license number and type.

La. R.S. 46:1974 · Louisiana guide

Montana

30 days firstAny animal

For any animal, a provider licensed in Montana with a client relationship of at least 30 days; the letter names the support this particular animal gives and the license effective date, number and type, for each animal.

Mont. Code § 70-24-114 · Montana guide

Iowa

No waiting periodAny animal

No waiting period, but the written finding must certify whether the relationship has lasted 30 days and cover seven more points, from the support the animal gives to an expiry date and whether a separate fee was paid. The template adds them.

Iowa Code § 216.8C · Iowa guide

Every other state's rules are in our ESA laws by state guide.

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ESA letter template questions

Yes. Fill in your part above and download the draft as Word: you get a .docx your provider can open in Word, Google Docs or Pages, review, edit and move onto their own letterhead, with their details still to fill marked in yellow. The PDF is a print-ready copy instead. There is no sign-up and no email to give.

Related: Who can write an ESA letter? · Are free ESA letters real?