Emotional Support Animal Letter From Therapist Template

You can open the Emotional Support Animal Letter From Therapist Template in multiple formats, including PDF, Word, and Google Docs.


Sample

Emotional Support Animal Letter From Therapist Template

Printable | Editable Form



Examples


Emotional Support Animal Letter From Therapist Template (1)
To Whom It May Concern:
I, [Therapist’s Name], am a licensed therapist in the state of [State] with license number [License Number]. My practice is located at [Therapist’s Address].
Patient Information:
This letter serves to certify that my client, [Client’s Name], has been under my professional care since [Date of First Visit]. [Client’s Name] has been diagnosed with [Specific Diagnosis] in accordance with the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition).
Emotional Support Animal (ESA) Recommendation:
Due to the nature of [Client’s Name]’s condition, it is my professional opinion that the presence of an emotional support animal is necessary to assist in their emotional and psychological well-being. The emotional support animal will provide [Client’s Name] with [specific benefits, such as companionship, support in social situations, etc.].
Specific Animal Information:
I recommend that [Client’s Name] be allowed to have [Type of Animal, e.g., dog, cat] as their emotional support animal. This animal has been determined to significantly alleviate symptoms associated with their condition.
Responsibilities of the Client:
[Client’s Name] understands their responsibilities regarding the care and management of their emotional support animal, which includes ensuring the animal is well-trained, behaves appropriately in public, and receives proper health care.
Conclusion:
This letter is provided to assist [Client’s Name] in gaining access to their emotional support animal in housing and travel situations. It is crucial to acknowledge the therapeutic benefits of emotional support animals in managing mental health conditions. Please feel free to contact me at [Therapist’s Phone] or [Therapist’s Email] should you need further information.
Sincerely,
[Signature of Therapist]
[Therapist’s Name]
[Therapist’s Credentials]
Emotional Support Animal Letter From Therapist Template (2)
To Whom It May Concern:
My name is [Therapist’s Name], a qualified mental health professional licensed to practice in [State]. My clinical license number is [License Number]. My office is located at [Therapist’s Address].
Patient Background:
I have been treating [Client’s Name] since [Date of First Visit]. They are receiving treatment for [Diagnosis and Symptoms]. This condition has significantly impacted their daily functioning and quality of life.
Need for an Emotional Support Animal:
After careful consideration, I believe that an emotional support animal is crucial for [Client’s Name] to mitigate their symptoms. The emotional support animal will provide them with essential support, helping to alleviate feelings of anxiety, depression, and loneliness.
Animal Specification:
I recommend that [Client’s Name] be permitted to have [Type of Animal] as their emotional support animal. This animal will play a vital role in their therapeutic process.
Client Responsibilities:
[Client’s Name] has been made aware of the obligations associated with being an emotional support animal owner, including proper care, training, and management of the animal.
Final Note:
This letter affirms the necessity of an emotional support animal for [Client’s Name] and is intended for use in housing and travel situations. For additional information, you may contact me directly at [Therapist’s Phone] or [Therapist’s Email].
Best Regards,
[Signature of Therapist]
[Therapist’s Name]
[Therapist’s Credentials]

Format

Please complete the form below to create the Emotional Support Animal Letter From Therapist Template. All fields must be filled out to ensure a clear and comprehensive letter. We provide examples to guide you through each step.

Emotional Support Animal Letter From Therapist Template

1. Therapist Information



2. Patient Information


3. Animal Information


4. Therapy Details

5. Purpose of the Letter

6. Recommendation Statement

7. Signature and Date


8. Verification of Authenticity


PDF


WORD

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Printable

Emotional Support Animal Letter From Therapist Template

Printable | Editable Form




Emotional Support Animal Letter From Therapist Template