at Fastcesa
a Letter
1111 street location, City State 00000
Office (111) 11-111
Jan 11, 2020
To Whom it may Concern:
| am a licensed mental health professional and have evaluated and assessed the history of the
functional limitations imposed by [The patient] emotional / mental related illness. After careful
review of [patient] mental and behavioral health condition | have concluded [The patient] has
certain limitations related to [Patient’s disability].
[The patient] has certain limitations related to [Patient’s disability]. [The patient] meets the
definition of disability under the Americans with Disabilities Act, the Fair Housing Act, and the
Rehabilitation Act of 1973.
In order to help alleviate the symptoms of [The patient] mental illness, and to enhance her
ability to live independently with full use of the dwelling unit you own and/or manage, it is my
recommendation that [The patient] should have an support animal. The presence of this animal
is supportive of the emotional and mental health of [The patient], as its presence will mitigate
the symptoms [patient] is currently experiencing.
Please allow [The patient] to be accompanied by the emotional support animal [Pet name] of
[Pet Breed] with approx. [Pet Weight] in [The patients] residence.
| am licensed by the state as a Mental Health Counselor. My license number is #00000.
Sincerely,
LMHC Name.
LIC# 000000
Issued: Jun 13, 2014,
