The process in detail
Intake (about 5 minutes)
Questions about your mental health history, current symptoms, daily-life impact, and how your animal helps. Not a screening quiz with a pass mark: it's the background your clinician prepares from.
Scheduling with a clinician licensed in your state
Your state's licensure is matched automatically. In 30-day states, this starts the statutory client-relationship clock, which is why starting early matters there.
The live evaluation
A private consultation with your clinician, typically by phone. Expect a genuine clinical conversation: your symptoms, their history, their impact, the animal's role. Confidential, HIPAA-covered, and typically the only appointment you need.
The clinician's independent review
After the consultation, the clinician makes their determination. This step is theirs alone; we don't influence it. That independence is the entire reason the resulting letter means something.
Same-day delivery
If the determination is yes, your letter is emailed the same day the review completes: letterhead, license details, signature, date, meeting your state's content rules, plus state-specific guidance on using it.
If something else fits better
Occasionally the clinician concludes an ESA isn't the right tool. When that happens you get the reasoning and real alternatives, not a form rejection, and that independence is exactly why the letters we do issue carry weight.
The four things scrutiny tests — built in
State licensure
Clinician licensed where you live, details in the letter, verifiable on your state board's site.
A real evaluation
The live consultation is the difference between clinical documentation and a purchased PDF; verification requests from landlords and universities are handled routinely.
State-rule compliance
30-day states honored, Florida's personal-knowledge standard met, required disclosures included.
Recency
Dated letters, annual renewal, and documentation that stays current with your state's rules.
After the letter: deploying it properly
The letter is the foundation; the request is the building. With your letter comes guidance for the three moments that decide outcomes:
Making the request
Formal, written, five required elements. The template →
Knowing your state
What force your letter carries where you live since May 2026. Your state →
Handling pushback
The lawful-vs-unlawful denial map and the escalation paths. The action plan →
Common questions
Current as of August 24, 2026.
How long does the whole process take?
Most states: intake today, evaluation as soon as it can be scheduled, letter emailed the same day the clinician's review completes. 30-day states: the statutory relationship period runs first; start a month ahead of any deadline.
Is the evaluation really live, or is it a questionnaire?
Live: a real conversation with a named clinician licensed in your state, typically by phone. The intake questionnaire is preparation for it, not a substitute.
What are my chances of approval?
We don't publish approval rates, deliberately: a rate high enough to advertise is a rate that advertises rubber-stamping. What we can say is that you don't need to be sure you qualify before starting; describing your situation honestly is all the preparation the evaluation needs.
Is everything confidential?
Yes: HIPAA-compliant platform, encrypted records, and a letter that documents your disability-related need without naming your diagnosis.
Do you handle landlord or university verification?
Yes. Verification requests go to the clinician, who responds as licensed professionals do. That verifiability is a feature: it's what registry certificates can't survive and real letters can.
Five minutes starts it
Intake now, evaluation soon, and, if the clinician approves, your letter the same day their review completes.