ESA Assessments & Letters

Honoring the connection while making sure it meets the guidelines

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Older adult smiling while sitting with their dog showing comfort companionship and emotional support gained through an emotional support animal assessment with Guidance Teletherapy

What Emotional Support Animals Are and What They’re Not

Emotional support animals (ESAs) can be a meaningful part of a person’s mental health care—providing comfort, connection, and real symptom relief. But ESA letters aren’t a guarantee, and they aren’t the same as a service animal designation. That’s why we offer a thoughtful, clinician-led assessment process that determines if an ESA is a clinically appropriate accommodation for you. Our goal is to balance client self-advocacy with clinical integrity—making sure ESA recommendations are accurate, ethical, and truly supportive of your well-being.

How We Work With ESA Requests

ESA assessments at Guidance Teletherapy are conducted by licensed clinicians trained in animal-assisted assessment. Depending on your history, needs, and the complexity of your situation, your clinician may request additional sessions or documentation from current or past providers. Your assessment will explore:

  • Whether you meet criteria for a mental health-related disability

  • Whether that condition significantly impairs daily functioning

  • Whether your pet plays a direct role in improving one or more of your symptoms

  • Whether there’s a clear clinical rationale for providing an ESA letter

Man hugging his dog and smiling showing connection trust and emotional comfort that reflects the supportive bond recognized through Guidance Teletherapy’s emotional support animal assessments

What You Should Know Up Front

ESA assessments are not therapy—they’re evaluations. Even if a letter isn’t issued, the time and clinical expertise involved is a billable service.

  • Not every person will qualify, and not every pet is clinically appropriate as an ESA.

  • These letters do not grant access to public places like restaurants or planes (the Department of Transportation no longer recognizes ESAs as accommodation for air travel).

  • These letters are primarily used for housing accommodation requests.

We’re transparent about all of this because we want to help you advocate effectively—and ethically—for what you need.

It is amazing how much love and laughter they [pets] bring into our lives, and even how much closer we become with each other because of them.

—John Grogan

Meet Our ESA Assessments Providers

Each clinician below is trained to provide ESA assessments and letters, and is licensed in the following states:

Image of Ariel Landrum, LMFT, ATR smiling warmly representing her compassionate leadership and expertise in providing ethical emotional support animal assessments and client advocacy

Ariel Landrum, LMFT

CA, KS, NV, FL, CO, OR, UT & ID

Image of Jessica Medina, LMFT smiling warmly representing her supportive and client-centered approach to emotional support animal assessments focused on comfort and connection
Image of Gregory Tilden, LMFT smiling professionally representing his knowledgeable and compassionate guidance in conducting emotional support animal assessments and documentation
Image of Stacey Inal, LMFT smiling confidently representing her clinical experience and dedication to helping clients access emotional support animal letters through a respectful and affirming process
Image of Serena Hsieh, LMFT, ATR-BC smiling gently representing her thoughtful and creative approach to supporting clients seeking emotional support animal evaluations with care and integrity

FAQs About ESA Letters

  • No. The outcome of the assessment depends on clinical findings. Completing the assessment does not guarantee a letter will be issued.

  • It varies. Some clients may need one session, others may need two or more. Your clinician will let you know what’s required after your initial intake.

  • Yes—if issued, they meet the criteria under the Fair Housing Act. We do not issue ESA letters for air travel or public access.

  • Not always. Please check with your plan. If not covered, this service is billed privately and payment is due regardless of the letter outcome.

Need an ESA Letter? Let’s Start with an Honest Assessment

We’re here to support you in getting the care you need—and that includes being clear about what qualifies. If you believe your pet plays a vital role in your mental health, let’s explore it together.

Request an ESA Assessment