Who can write an ESA letter? Provider types and state rules

Who qualifies to write an ESA letter?

In general, a licensed professional whose license covers assessing mental or emotional conditions, and who has evaluated you, can document a disability related need for an emotional support animal. HUD's regulation at 24 CFR 100.204 requires reasonable accommodations but does not list provider types, and HUD's May 22, 2026 memo set no new documentation standard. State laws fill in the details.

That matters because the 2026 memo narrowed HUD's federal enforcement for untrained ESAs, which puts more weight on state law and on the quality of the letter itself. A letter from a clinician licensed in your state, after a real evaluation, is the kind of evidence state agencies, colleges and courts rely on. See our guide to HUD's 2026 guidance.

Provider types at a glance

The table summarizes common provider types. Scope of practice and state statutes decide the details, so treat it as a starting point.

Can a therapist write an ESA letter?

Yes. Licensed therapists, including LCSWs, LPCs, LMHCs and LMFTs, are among the most common ESA letter writers because assessing how symptoms affect daily life is central to their work. Pet ESA Service clinicians are licensed mental health professionals such as LCSWs, LPCs, LMHCs, LMFTs and psychologists, matched to your state, and their clinical decisions are independent.

Watch for state limits. Kentucky's KRS 383.085 lists Kentucky licensed clinical social workers, professional counselors, APRNs, psychologists and physicians with an active Kentucky practice, so an LMFT letter may not fit that list. In Colorado, mental health licensees, including counselors and social workers, must have met you in person before making a written finding under C.R.S. 12-245-229.

Can a primary care provider or nurse practitioner write one?

Often, yes. A primary care physician who knows your history can document a disability related need, and in Colorado physicians may make the finding in person or by telemedicine. Nurse practitioners are named in Kentucky's, Indiana's and Maine's statutes, though Colorado requires nurses to have met you in person.

Some primary care doctors prefer to refer ESA questions to a mental health specialist, especially when they mainly treat your physical health. If yours declines, our guide on asking your existing provider covers next steps.

Can you get an ESA letter without a doctor?

Yes. No federal rule requires a medical doctor, and state statutes that list providers include licensed mental health professionals. Montana's statute, for example, looks to a Montana licensed mental health professional. What you cannot skip is a licensed professional and a genuine evaluation.

Telehealth evaluations are common when the clinician is licensed where you are located and actually evaluates you, but some states are stricter about paid documentation. Oklahoma presumes documentation acquired through payment for goods and services fraudulent, Tennessee excludes websites whose primary function is selling certificates, and Kentucky excludes providers whose primary service is selling letters. Our article on registries versus clinical documentation explains the difference.

State license requirements to know

Several states set rules about where the writer is licensed and how long they have known you. Whoever writes your letter, you can check their license on the state board's website, and our state law hub lists each state's rules.

• California: for emotional support dogs, a practitioner licensed where you are located, a 30 day relationship and a clinical evaluation (H&S Code 122318)
• Montana: a Montana licensed mental health professional with a 30 day relationship and personal knowledge of the disability, or another source the landlord finds reliable (MCA 70-24-114)
• Louisiana: a Louisiana license or compact license, a 30 day relationship and at least two sessions (Act 558 of 2024)
• Kentucky: a Kentucky licensed provider with an active Kentucky practice; people who moved may use a former state provider with an ongoing relationship (KRS 383.085)
• Colorado: mental health licensees and nurses must have met you in person; physicians may use telemedicine (C.R.S. 12-245-229)
• Arkansas: for emotional support dogs, a provider licensed where documentation is provided, a 30 day relationship and a yearly evaluation (Act 268 of 2023)

Find a clinician licensed in your state

If you do not have a provider who can write a letter, start the free assessment. Pet ESA Service matches you with a licensed mental health professional licensed in your state, and if they do not approve your completed assessment, you receive a full refund.