Ever since I wrote the article How Do I Get a Prescription for a Service Dog, I’ve had quite a few people ask about how to get a doctor’s note. They have asked what doctors can write a note, how to ask their doctor about a service dog and what a doctor’s note should say.
Well, let’s get down to brass tacks and get specific!
Why You Need a Doctor’s Note for a Service Dog or ESA
Doctor’s notes are for a few things:
- Having an assistance dog in a rental.
- Help defend yourself in case you have to go to court
- If you press charges or report a business that decides to not follow the ADA
- When you take an emotional support dog on an airplane. When you need to support claims that you need a service dog, in case you are challenged at an airport.
- Possibly to get a service dog from a program and sometimes to train with a service dog trainer.
If a business ever asks you to show a doctor’s note for your service dog, you do not have to. You don’t need to carry your doctor’s note around with you ever. Or cards. Or even make your dog wear a vest (if you don’t want to). The article How Do I Get a Prescription for a Service Dog covers all of this.
An ESA can’t go into businesses unless the business is “pet friendly”.
Why Would You Need a Doctor’s Note for Airlines?
It’s because airlines follow the ACAA (air carrier access act) instead of the ADA.
If you like reading technical stuff, here’s the pdf that talks specifically about service dogs and emotional support animals.
The ACAA says, basically, that an airline can require documentation for emotional support animals and that it will make things easier to have documentation if you have an “invisible disability” and a service dog. They can ask for documentation for service dogs.
For people with service dogs, the airline is also supposed to accept ID cards, “other written documentation”, tags and proper answers to questions about what tasks the dog performs – but it’s still best to carry a doctor’s note in case they don’t believe you, because in that case they can require it.
The ACAA does not require that service dogs in training be allowed on airplanes. Service dogs in training rules are left up to the airlines to decide, so you need to research/call the airline if you have a dog in training.
Why Would You Need a Doctor’s Note for Housing?
Landlords to whom the FHAct, Section 504 and the ADA apply must follow the law on the HUD website.
The HUD law says that reasonable accommodation is required for anyone with an assistance animal, trained or untrained, even if the landlord does not allow pets.
An assistant animal, they say:
[…] is not a pet. It is an animal that works, provides assistance, or performs tasks for the benefit of a person with a disability, or provides emotional support that alleviates one or more identified symptoms or effects of a person’s disability. Assistance animals perform many disability-related functions, including but not limited to, guiding individuals who are blind or have low vision, alerting individuals who are deaf or hard of hearing to sounds, providing protection or rescue assistance, pulling a wheelchair, fetching items, alerting persons to impending seizures, or providing emotional support to persons with disabilities who have a disability-related need for such support. For purposes of reasonable accommodation requests, neither the FHAct nor Section 504 requires an assistance animal to be individually trained or certified.
And then “qualifying” landlords are told to ask these two questions:
(1) Does the person seeking to use and live with the animal have a disability — i.e., a physical or mental impairment that substantially limits one or more major life activities?
(2) Does the person making the request have a disability-related need for an assistance animal? In other words, does the animal work, provide assistance, perform tasks or services for the benefit of a person with a disability, or provide emotional support that alleviates one or more of the identified symptoms or effects of a person’s existing disability?
If the answer to both questions is “yes”, then they will need to allow that person to have their assistance animal.
This is where the doctor’s note comes in—the landlord is allowed to ask for documentation to prove the dog is an assistance animal, which they will likely do unless the disability is very obvious and the dog is clearly providing for the disability, like a guide dog for someone who is blind.
Who Can Write a Doctor’s Note for a Service Dog or ESA?
If you’re ever planning to take your ESA on an airplane, your note needs to be written by a health professional to be able to be used.
The only quality the health professional has to have is a license.
A health professional can be your regular medical doctor, your psychiatrist, a psychologist, a licensed therapist, vocational case manager, licensed clinical social worker, etc. Anyone who is working with you on your mental or physical disability and has a license.
How To Ask Your Doctor for a Prescription for A Service Dog (or Emotional Support Animal)
This can be especially difficult if you have anxiety.
A lot of people have a hard time suggesting things to their doctor. I know I sometimes think that if my doctor thought I needed something, they would have already offered it. However, doctors don’t usually think about service dogs or emotional support animals, quite honestly.
It’s not that doctors don’t think that an animal might help. It’s usually because they have certain things they offer patients on a regular basis and a service animal isn’t at the top of the list.
So just because your doctor hasn’t said to you “Hey, what about a service dog?” doesn’t mean they’d be opposed to it. A good doctor will listen to you when you ask about something and tell you their professional opinion. If you have a doctor that doesn’t, you should switch doctors.
Here are some ways to ask:
“I have been talking to someone who also has [disability] and they say a service dog (or emotional support animal) helps them a lot. Do you think that a service dog might help me?”
“I read about how service dogs can help people with [disability] recently. Do you think a service dog would be a good choice to help me?”
“I think a service dog might help me with [disability] because [why your disability makes life hard and what a service dog can do to help with that]. I’d like to get a doctor’s note from you so that I can get/train one.”
If your doctor says yes, then you can say:
“Can you write me a note?”
“I will need a note to make sure that I can take the service dog certain places, could you write me one?”
If your doctor says no, ask them to explain why. If what they say doesn’t make sense, you may need to get a second opinion.
What Should My Doctor’s Note for my Service Dog Say?
Your doctor’s note should be very specific if you want it to be accepted.
It will need to be on your doctor’s “letterhead”. This means it needs to give your doctor’s information.
A letterhead should have:
- The doctor’s name with any “attachments” (for example, Dr. John Smith, M.D. or Sarah Smith, LCSW)
- Their address
- Their phone number
The actual letter should have:
- A date within the last year (Get a new one every year!)
- A statement that you have a physical or mental disability.
- That having the dog with you is necessary to your mental or physical health, or your treatment, or to assist you with your disability.
- That you are under the care of the person writing the note and that the person writing the note is a licensed medical professional. (This includes the doctor’s licensing information: the date it was issued, what state/jurisdiction it was given in and what license it is.)
See/download a sample note here!
When Will a Doctor’s Note Not Help?
If your dog is acting aggressive, noisy, uses the bathroom on the floor, or is being disruptive to others, a doctor’s note will do nothing for you.
Your dog must be extremely well-behaved in all situations if you want your doctor’s note to mean something.
What if an Airline/Landlord Denies Me Despite Having a Doctor’s Note for My Service Dog?
Before someone asks you to not get on the plane, they should help try to fix whatever is the issue. For example, asking you to muzzle a barking dog, giving you a decent amount of time to correct the issue, offering a different seat, etc.
If you disagree with someone’s reasons for not letting you on a plane, ask to speak with the airline’s complaint resolution official (CRO.) The CRO will decide who is correct, and then they have to write down why you were denied access (if they decide you can’t get on the plane) and give a copy of what they wrote to you.
File a complaint with HUD if you are denied housing unfairly.
Good Luck!
Just remember, in the end you don’t have to have a doctor’s note for a service dog in most cases. It’s just a good idea to have one lying around to help make things easier for you.
thank you so much for this info. i really could find anything on it that made me feel like i new what i was talking about to the doctor or landlord. ppl like you make this world great. i shared this on many fb pages that im on for other families with sp needs children. that is the reason i was looking for info, so my 2 kids who have ASD, ADHD and emotional sensory and anxiety can keep growing in a healthy way. i to benefit from having our dog. she is more therapeutic then i ever realized. with all that goes on with my kids, i also needed someone to just be there.
I suffer from anxiety and sometimes i don’t want to leave the house how do i apply for a service dog to help me get out and about
Your anxiety has to be classified as a disability and you must have it perform three or more tasks but from what you said here it doesn’t look like yours qualifies for one as you just said you cant leave the house (not meaning to say it isn’t a problem) but from what I see I suggest talking to a therapist and seeing whether or not you are qualified one
Actually, a service dog only needs to perform (at least) one task to qualify as a service dog.
Actually, anxiety/can/ be considered a disability. There wasn’t much given, but it can cause fainting, selective muteness, separation anxiety(yes, in people too), panic attacks, severe heart palpitations, etc.
Why do you say that you have to get a letter from the doctor every year? I cannot find anything on the ADA.gov or HUD.gov or the FHACT that says that. Could you please send me the link to that information? Thank you
It’s mostly because of the Air Carrier Access Act that you will want to get a new one every year. The HUD only requires that there be some sort of “reliable” documentation of disability provided from a healthcare provider; it’s pretty vague. The ADA just requires that documentation of your disability exists somewhere. However, lots of people do fly with their service dogs, so it’s just good to keep in the habit of getting a new note every year in case you decide to fly someplace – that way you aren’t scrambling last minute and don’t have to think about it. I just do it when I do my yearly checkup.
Also, many people like to “cover their butt”, so to speak, just in case there is a court case either brought against them or they need to bring a case against a discriminatory place/person… having a new note every year helps make sure that you have a good, reliable paper trail so you are covered.
The ACAA states:
(e) If a passenger seeks to travel with an animal that is used as an emotional support or psychiatric service animal, you are not required to accept the animal for transportation in the cabin unless the passenger provides you current documentation (i.e., no older than one year from the date of the passenger’s scheduled initial flight) on the letterhead of a licensed mental health professional (e.g., psychiatrist, psychologist, licensed clinical social worker, including a medical doctor specifically treating the passenger’s mental or emotional disability) stating the following:
(1) The passenger has a mental or emotional disability recognized in the Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM IV);
(2) The passenger needs the emotional support or psychiatric service animal as an accommodation for air travel and/or for activity at the passenger’s destination;
(3) The individual providing the assessment is a licensed mental health professional, and the passenger is under his or her professional care; and
(4) The date and type of the mental health professional’s license and the state or other jurisdiction in which it was issued.
I am physically disabled and fall allot causing myself more injuries and sometimes laying where I fell for long amounts of time till someone comes home or See’s me. My landlord has a zero pet policy not even a gold fish they said. They also told me the previous tenant had a note from her PA which they called a glorified nurse. Anyway it for a companion pet. The landlords told me they told the tenant repairs where needed in house so she would need to move out so they could do the repairs. We moved in 2 days after she moved out their were no repairs just a excuse. I really need a service dog to help me get up when I fall or get help but I am extremely worried what my landlord will do.
A landlord restricting you against getting a service dog is against the law and if they do, they would face a pretty hefty fine. Having a dog for assistance allows you to have a dog in places where there are no pets allowed like housing areas, public places, transportation, etc.
You also don’t need to pay anything for pet fees for where you live if your landlord is to challenge you to pay for the dog to live with you because that too is against the law. You don’t have to be worried about your landlord because as long as you have documentation and know your rights about having a service dog, you’ll be fine. BUT if you were to get an Emotional Service Animal, that would be a different story since they are looked at as a companion and not as an actual service dog. Regardless, you’ll be fine since you need a dog to help you get up.
Just to clarify – ESAs are actually also legally allowed to be housed in non-pet housing, per the FHA (as long as the landlord is subject to the FHA).
They cant leagally do anything but if they do take them to court or file a complaint. talk to them about it beforehand to
if you have a service dog by law it required by law to be able to live in no pet homes. I live in a no pet home but I have a service dog and my owner let me keep my house
I have a small standard poodle I’m very interested in. She is so sweet and getdfď
Thanks for sharing.
Great Article on Service Dogs/ Emotion Support Animals. Thank you for publishing this information. By Gregg L. Friedman MD Psychiatrist.
My pain care specialist gave me a difficult time today about my service dog. He said nothing at my appointment 3 months ago, but today he said they don’t want dogs in the office, that he is allergic, that a pet that can get stuff for me isn’t a service animal, that I need certification, that I need a letter from my doctor, etc., etc., etc. I looked up the ADA requirements and none of these things is correct. I had polio and have difficulties walking and doing other things. I got the dog specifically to train as a service dog to help me as my disability progresses with my age (73.) He told me to leave the dog in the car when I come to the office. I do not think any of this is right.
My pain care specialist gave me a difficult time today about my service dog. He said noathing at my appointment 3 months ago, but today he said they don’t want dogs in the office, that he is allergic, that a pet that can get stuff for me isn’t a service animal, that I need certification, that I need a letter from my doctor, etc., etc., etc. I looked up the ADA requirements and none of these things is correct. I had polio and have difficulties walking and doing other things. I got the dog specifically to train as a service dog to help me as my disability progresses with my age (73.) He told me to leave the dog in the car when I come to the office. I do not think any of this is right.
Yes, he is incorrect. As long as your dog is trained as a service dog, then you are allowed to bring your dog with you to his office – whether he is allergic or not. This is something you could probably take to court if he denies you service. It’s like asking you to come without your oxygen – a service dog is important medical equipment.
Thanks you,my dog is my best friend,helps with depression,train by me and care giver,when glucose hi,bows head,ears back,uneasy,then low steps by me licks my face,and tail wags fast,,could lose both feet,Sharko foot,bone degerative bone lose,other foot,no weight bearing on left foot,due to stepping on a broken shard of clear all bowl,small ,infected dab,three days later got really bad,first dr,gave wrong antibiotic,,three days saw foot dr,(who really good)found what infection was really,first gave K-pled,wrong inflamed ,eating away outer right foot little toe to heal,then put on Bactrim?infection gone four days now trying to heal,no weight bearing,hard to get an wheelchair,other devices don’t help with the weight,I’m 300 pound native,preferred medical never told Dr, or her nurse that they no longer help Medicaid patients,so wasted a week waiting,never told or called me about changes,ask why the two woman says to busy,now Linncare gonna order get one,real helpful, came home ready to give up,have a bunch of other stuff going on,diabetas,renal failure stage three,cirrousous,gout,arhritas,cardidomonopothy,,back,lost right ring finger fron diabetas also,so felt down can’t have my dog here,I moved to town house to small for my need my gal doing carpel tunnel,both hands,hip replacement,then another the other,shoulder issues,here wheel chair ok,get around,we can’t take care of each other’s needs,almost destroyed us,our life,moved to town,thank you in this matter,I’m 62 years old I need him,max ,pit,chocolate lag,friendly,loving,caring dog,color like creamer n black coffee,never thought depend on a dog or love him like family,I need him ,so thank you in this matter,blessings,prayers,GOD BLESS to All people. Joe Sth.
I need a Service Dog but i read that they are like 17,000 dollars? jeez my coast less i dont have the money 🙁 im poor
You can technically use any dog as a service animal: even ones from the shelter! Talk to someone that works with the dogs and they can help you pick one that shows the potential for what you would be training it for. I self trained my service dog, I later paid for training from a couple different places because some antibiotics that were given to her caused reversible brain damage. That training cost me about $4,000 in a span of a year. As long as you can afford to feed, vet, etc you should be fine 🙂 it’s just a matter of a lot more searching to find what works for you!
You can always rescue an animal (dog, or miniature horse) and train him/her yourself for 120 hours total and 30 hours in public over a 6 month period
Im only 30 yrs old and dont have an significant disabilities per say, but i do have issues with severe Irritable bowel syndrome once or twice a week and occasional problems with balance, i’ve fallen twice in the past year: once in the shower and the other was down some apartment stairs. My fiance deploys soon and would feel better if i had some kind of service dog with me, a mutual friend has a german shepard that she thinks would work very well for me in that regard. but the apartment i live in doesnt allow that breed, would a doctor consider my issues enough to issue a letter or certificate for me to use her as a service dog so that i could have her at my apartment
Hello, I wanted to know dose your doctors note protect you from a business denying you service? For example a companies policy at least in Canada may say only certified service dogs are allowed. I am trying to prove that thier business has to accept my doctors note. It would be under the authority where my doctor got his license that says my dog is a service dog. I was really harassed about it and even told a doctors note dosent qualify your dog being a service dog! Now I say, the province who gave my doctor his linsence, authurizes me to have my service dog with me. I have a hard time explaining this maybe you could that business has to accept a doctors note even in the states any information helps I know I got a case because my do yours note was regretted my dog is not certified but he is by my doctor I really had to stand up for my self. Thank you!
Correction I know I got a case because my doctors note was regected.
Certification of guide and service dogs is standard not mandatory in Canada much like the states. The problem is people don’t get that. May any one help me prove this? So far a lawyer says I have a case I went to human right it was dismissed but I did not have the information I do now. Dose a doctors note qualify your dog to be a service dog I need the proof
I have been listed as PURE Deaf’ due to a stroke 1982. “i recently moved from IL to FL and into a senior Hud apartment complex. The manager wanted a letter from my Dr. I did have a letter saying That Dear To Whom it May Concern, Kathleen Groves is hearing impaired and she would benefit having support/service dog at her residence… The manager says it is not acceptable and says I Need a service dog! Isn’t an assistance dog considered a support/service dog when my dog barks at knocks, when phone rings, when microwave or oven timer buzzes etc? Now she wants me to pay $300 pet deposit since she says my dog is only a pet, and for me to go to a fully new Dr who doesn’t have my many years of medical records or anything.. i think i need to ask Hud if my Dr’s Letter is approvable.
Sincerely,
What about a veteran whos suffers from PTSD.
Generally, what percentage of “licensed mental health care professionals” are on board with writing a note or even believing in the benefits of a psychiatric service dog? As with most doctors, they get a “kick back” from all the medications they prescribe by the pharmaceutical companies. But if you are just not tolerant of any of these medications, (and I’ve tried them all!!), it seems that acquiring a service dog is the only alternative left. Also, I know you have to participate in the training, and if one of the things you suffer from is Agoraphobia, it makes it a little difficult to travel. I travel SOME….but the only places I have been able to find that specialize in the training of the kind of dog I would need are several states away. Any answers for the first question?….or suggestions for the later? Thank you!!!
Unfortunately the number of physicians willing to write notes is fairly limited. The best thing to do is call around and ask doctors offices near you if they are familiar with service dogs for mental illness. Otherwise, it will be a matter of informing your physician of how service dogs work and what you would need one for, etc.