Sample letter format

To Whom It May Concern:

I am an APRN licensed in the State of Florida (License No. APRN9355049). I have a professional relationship with [Patient full name] involving the provision of health care or disability-related services, including the clinical evaluation referenced in this letter.

Based on my evaluation, [Patient] has a physical or mental impairment that substantially limits one or more major life activities. This individual has a disability-related need for an assistance animal.

Based on my clinical evaluation, this individual’s disability-related needs are alleviated in part by the therapeutic emotional support provided by the animal(s) identified below. The animal(s) are not recommended merely as pets.

Animal(s) for which accommodation is requested

• Animal 1: dog · [breed if known] · “[Name]”

This documentation is provided in support of a reasonable accommodation request under the Fair Housing Act. It is not a certification of public access rights equivalent to a trained service animal under the ADA, and it is not intended for airline cabin travel policies that no longer recognize emotional support animals.

This letter is valid through [valid-through date] (one year from purchase/issue, unless a shorter period is clinically indicated).

Housing providers may contact the undersigned to verify licensure and the existence of this evaluation. Providers should not request detailed medical records beyond what fair housing guidance permits.