A diagnosis name does not decide the request
Anxiety and depression are common terms in ESA searches, but a professional needs to understand the individual person and purpose of the documentation. A diagnosis label, online quiz score, or self-description alone cannot guarantee that a letter is appropriate.
NIMH provides mental health information and encourages seeking professional help when needed. An ESA-related appointment should not be treated as a replacement for needed ongoing care.
Describe your own observations
Prepare examples of how difficulties affect sleep, routines, concentration, or participation in everyday activities, as relevant to your experience. Explain what changes when your animal is present and what does not change. Do not exaggerate symptoms or copy an answer intended to secure approval.
Also discuss the responsibilities of care. If feeding, walking, costs, or supervision are difficult, say so. The conversation should include the realities of living with the animal, not only the hoped-for benefit.
Keep clinical and housing outcomes separate
Tell the clinician why the document is requested and bring any housing form. The professional may recommend documentation, need further assessment, suggest other care, or conclude that a letter is not appropriate. Ask about the service process before paying.
If documentation is issued, use it for the purpose discussed and request the housing adjustment through the relevant process. Our assessment guide and housing guide explain those separate steps. A supportive relationship with an animal does not itself guarantee a particular accommodation.
Sources & reading notes
Sources consulted September 8, 2026. Source addresses are provided as text for reference. General information does not replace individual medical or legal advice.
NIMH — Caring for Your Mental Healthhttps://www.nimh.nih.gov/health/topics/caring-for-your-mental-health