Emotional Support Animals & ESA Letters, Explained

Here's what to know when getting official certification for your ESA.

Team LemonadeTeam Lemonade

Emotional support animals, or ESAs, are an essential part of life for many people struggling with mental health concerns.

It’s important for ESA owners to have their assistance animals nearby, which often means navigating hurdles when it comes to homes or apartments with a stated “no pets” policy. However, this shouldn’t be a problem as long as the tenant has an official ESA letter verifying their legitimate need for the emotional support animal.

Read on to learn more about emotional support animals, why you may need an ESA letter, how to get one, and whether or not your landlord can deny an ESA. (The following content was written by the team at DogCentral.org, with research support from WiseGeek.)

After you’ve got your ESA sorted, you’ll also want to get your emotional support dog or cat protected with pet health insurance. Get your quote with Lemonade Pet today—it’s fast, simple… and even delightful.


What is an emotional support animal (ESA)?

While all pets offer comfort and love to their owners, the role of an emotional support animal is a little different. Emotional support animals can help people cope with mental illnesses or emotional disabilities.

It’s easy to confuse emotional support animals, service dogs, and therapy dogs. So what are some of the differences?

While emotional support animals provide comfort to people struggling with mental or emotional disorders, service dogs help people with physical or psychiatric disabilities carry out tasks that they cannot do for themselves. Service dogs also require significant training to carry out their role, whereas emotional support animals do not need any specific training.

By contrast, a therapy dog is trained to offer comfort and love in places like hospitals and nursing homes.  

While service and therapy animals are usually dogs, an emotional support animal can be almost any animal. However, if you are planning to live in an apartment with your ESA, think realistically about what kinds of animals are suited to apartment living. Certain dog breeds may do better than others in small living spaces because of their temperament and personality.

Take this short quiz to see if you pre-qualify for an ESA.

Who needs an ESA?

There are many reasons why someone might need an emotional support animal. Emotional support animals can help their owners with their mental health needs by offering the three Cs: companionship, consistency, and comfort. For example, an ESA can give its pet parent a sense of purpose and relieve anxiety by helping them maintain a steady routine each day.

Furthermore, interacting with animals can help lower blood pressure, reduce anxiety, and alleviate symptoms of depression. Interacting with animals also causes the human body to release feel-good hormones that can lift a person’s mood.

Some of the common reasons for getting an ESA include depression, ADHD, bipolar disorder, anxiety, and PTSD, among many others. If you struggle with any of these conditions, you might consider getting an emotional support animal and an ESA letter.

How do you get an ESA letter?

The process of obtaining an ESA letter can vary slightly, depending on which service you use, but there are a few steps that should always be part of the process.

First, you will likely have to complete some sort of online assessment about your mental health and ESA needs.

Next, if you are using a legitimate ESA letter provider, they will schedule a consultation for you with a licensed mental health professional. This consultation could happen in person, over the phone, or through a video call. If you find a service that promises to give you an ESA letter without having you speak to a medical professional, this should be a red flag that the provider and their ESA letter service are not legitimate. 

After your consultation with a licensed mental health professional, you should hear back about whether you’ve been approved for an ESA letter or not. A mental health professional licensed in your state is the only person who has the legal authority to issue you an official ESA letter. The easiest and most secure way to get a legitimate ESA letter online is through a reputable provider.

When you have an emotional support animal, landlords must waive all pet fees, pet application fees, and pet deposits. Your landlord will likely only waive these payments if you have an ESA letter for housing. However, if you’re renting an apartment with an ESA, keep in mind that your landlord can still seek payment from you if your support animal  damages the property or causes harm to anyone in the building. 

You may also need to renew your ESA letter if you plan to submit it to a landlord more than a year after initially receiving one. Many ESA letter providers offer an annual renewal service to help you ensure your letter is up to date.

Best ESA providers online

Unfortunately, there are many websites that try to sell ESA letters that are not valid or legitimate. Sometimes, it’s difficult to tell the difference between reputable sites and ones that are trying to scam customers. 

On the bright side, there are a few online ESA letter providers that offer a fast, user-friendly, and entirely legitimate service—and they have the reputation and good customer reviews to prove it.


Pettable is trustworthy and well-reviewed, and their team of licensed therapists, legal experts, and customer support representatives will work with you through each step of the process to ensure that you get a valid ESA letter for housing


  • Pettable starts the ESA approval process by giving you a short online assessment so they can set up your consultation with a licensed mental health professional. 
  • After that, you’ll have a video consultation with a therapist who is licensed in your state. 
  • If the therapist feels that your mental health would benefit from the presence of an ESA, you’ll receive your ESA letter within 24 hours of getting approved. 


  • Pettable offers fast and legitimate help to people in need of official approval for their emotional support animal. 
  • Pettable’s letters are compliant with the Fair Housing Act, the Air Carrier Access Act, and HIPAA regulations.
  • The company offers quick turnaround time for official ESA letters. They have a dedicated customer service team, and offer a money-back guarantee.


  • You must provide an email address and phone number to see pricing options.
  • You must pay in full before your consultation. However, Pettable will refund you 100% of the fee if you don’t end up qualifying for an emotional support animal letter. 


CertaPet is similar to Pettable in some ways, including their three-step process to get an ESA letter, but without the money-back guarantee. 


  •  First, you will need to take a free screening test. This will determine whether you’re a good potential candidate for an ESA letter.
  • Then, you’ll have a telehealth appointment with a licensed therapist or a licensed medical professional in your state. 
  • If you’re approved, you’ll get a “custom treatment plan.” This will include an ESA letter that will be sent to you within 48 hours. 


  • Residents of the United States (including Puerto Rico) and Canada can use CertaPet.
  • The process is quick. You can schedule a phone consultation within a couple of days of completing the online screening test.
  • You can print a copy of your ESA letter after qualifying.
  • It’s easy to request a mailed copy of your ESA letter.


  • You have to pay a $35 consultation fee even if you don’t end up qualifying for an ESA letter.
  • CertaPet charges extra if you have multiple support animals.
  • You must pay the entire ESA letter fee before completing your evaluation.

ESA Doctors

ESA Doctors is another option to consider when choosing an ESA online provider. ESA Doctors offers a similar telehealth service and ESA letter approval process. 


  • First, click the “Get Started” button on the ESA Doctors website. This will take you to an online questionnaire. A licensed mental health professional will review your answers.
  • Then, you will submit your payment information.
  • You will then work with a licensed therapist to get your ESA letter.
  • If your need for an ESA is approved, ESA Doctors will send you a digital copy of your ESA letter within one to three business days. 


  • ESA Doctors issues letters that are compliant with the Fair Housing Act.
  • They offer express service availability.
  • They offer landlord-requested confirmations.
  • ESA Doctors offers a 100% money-back guarantee if your licensed healthcare professional determines after an assessment that you do not qualify for an ESA letter or PSD letter.


  • ESA Doctors does not list their company phone contact information on their website.

As you can see, all of these providers have their advantages and drawbacks, so it’s best to explore each one before deciding which service is best for you. 

What are the benefits of having an ESA letter?

Having an ESA letter shows others, including your landlord or apartment manager, that you have a medical need for your emotional support animal. An official ESA letter verifies that your support animal helps you cope with a mental or emotional struggle that is not visible in the same way that a physical disability is. 

Sometimes, it can be difficult to show others that you are dealing with mental illness, but an ESA letter shows that a licensed professional acknowledges your condition and your need for a support animal.

Most people get ESA letters for housing purposes, but there are other benefits, too. Because your ESA letter proves that you have a need for your emotional support animal, it may help you keep your ESA close to you in various public places.

Some airlines and restaurants may acknowledge the legitimacy of an ESA letter, but they’re not legally required to accept animals, except for service animals. If you want to bring your emotional support animal with you when you’re traveling or going out, it’s best to contact the airline or restaurant first and check their policies on pets and ESAs. 

They may ask to see your ESA letter, so it’s important to keep a copy of your letter with you. They will probably accept either a digital copy or a physical copy.

Sharing your ESA letter with your landlord or apartment manager

One of the most important reasons to get an ESA letter is to use it as supporting evidence when you tell your landlord about your ESA.

It’s important to be upfront about your emotional support animal when discussing your living arrangements with your landlord or apartment manager. Landlords and apartment managers are legally required to offer you reasonable accommodations for your emotional support animal under the Fair Housing Act, but there are a few things to keep in mind. 

The Fair Housing Act states that landlords can’t discriminate against tenants for a variety of reasons, including disabilities. While this is true, landlords only need to offer reasonable accommodations for you and your assistance animal. So although your landlord can’t deny an ESA because of a “no pets” policy, they only have to provide reasonable accommodations for ESAs. For example, if your emotional support animal is a miniature horse, it’s not reasonable to expect to live with it in a rented top-floor apartment. 

When you have an emotional support animal, landlords must waive all pet fees, pet application fees, and pet deposits. Your landlord will likely only waive these payments if you have an ESA letter for housing. However, if you’re renting an apartment with an ESA, keep in mind that your landlord can still seek payment from you if your support animal  damages the property or causes harm to anyone in the building.

It’s important to find a place that will allow you and your emotional support animal to live together comfortably and safely. The Fair Housing Act protects tenants and their specific needs, so don’t be afraid to speak with your housing provider about your ESA and the legitimate accommodations you may require.

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