Emotional Support Animal (ESA) Request Form

Universities are committed to providing an inclusive learning environment for all students, including those who rely on an Emotional Support Animal (ESA) as a reasonable accommodation for a disability. This page explains the purpose of the ESA request form, the documentation required, the review process, and student responsibilities.

Why an ESA Request Form Is Needed

An ESA is not a service animal; it does not require specialized training but offers therapeutic benefits to its handler. Because an ESA may occupy housing or classroom space, the university must verify that the request is legitimate, consistent with federal regulations (e.g., ADA, Fair Housing Act), and compatible with campus policies. The request form creates a clear, documented record for both the student and the Office of Disability Services (ODS).

Eligibility Criteria

To qualify for an ESA accommodation, a student must:

• Be enrolled at the university (fulltime or parttime).
• Have a disability that substantially limits one or more major life activities.
• Demonstrate that an ESA provides a therapeutic benefit that mitigates the effects of the disability.
• Provide current, professional documentation as described below.

Documentation Requirements

All supporting documents must be dated within the past year and signed by a qualified mental health professional (e.g., psychiatrist, psychologist, licensed clinical social worker, or licensed professional counselor). Acceptable documentation includes:

• Letter of Diagnosis: Confirms the students disability without disclosing detailed medical history.
• Professional Statement: Explains why an ESA is a reasonable accommodation and how it helps the student.
• Signature and Credentials: Includes the providers name, title, license number, and contact information.

The university does not require the specific type of animal, but the animal must be domesticated and capable of living in a university setting.

How to Complete the Form

Student Full Name Student ID Number University Email Degree Program / Major Disability (Brief Description) Mental Health Providers Name Provider License Number & State Professional Letter (PDF, JPG, or PNG, max 5MB) Animal Information (type, breed, age) Housing Preference (Dorm, Apartment, OffCampus) Select... OnCampus Housing OffCampus Housing No Housing Change Requested

By submitting this form you agree to provide the animals vaccination records within ten business days of approval and to comply with the universitys animal behavior and health policies.

Submit Request

Review Process

Once submitted, the Office of Disability Services will:

1. Confirm receipt of a complete form within two business days.
2. Verify the providers credentials and the recency of the documentation.
3. Assess whether the ESA is a reasonable accommodation based on the students disability and the universitys policies.
4. Consult with Housing Services, Campus Security, and, when appropriate, the Academic Dean to coordinate any necessary adjustments.
5. Communicate a written decision to the student within 15 calendar days.

Possible Outcomes

• Approved: The student receives written confirmation, any required housing modifications, and a list of responsibilities.
• Conditional Approval: Approval is granted pending submission of additional documentation (e.g., vaccination records) or minor modifications (e.g., specific housing location).
• Denied: The student receives an explanation of the decision and information about the appeal process.

Student Responsibilities

After an ESA accommodation is approved, the student must:

• Provide uptodate vaccination and health records for the animal.
• Ensure the animal is housebroken, leashed or contained in public spaces, and under control at all times.
• Respect any reasonable restrictions (e.g., no ESA in labs, clinical settings, or certain residence halls).
• Address any damage or disturbance caused by the animal and reimburse the university for related costs.
• Notify ODS promptly about any change in the animals health status or if the ESA is no longer needed.

Frequently Asked Questions

Can I bring any type of animal?

The ESA must be a domesticated animal, such as a dog, cat, rabbit, or small rodent. Exotic or farm animals are not considered reasonable accommodations.

What if my roommate objects to the ESA?

The university will attempt to find a housing solution that respects both parties. This may involve assigning the student to a different room or residence, when possible, while still respecting the students accommodation rights.

Do I need to provide a training certificate for my ESA?

No. Unlike service animals, ESAs are not required to have specialized training. However, the animal must behave appropriately in shared spaces.

How often must I renew my ESA accommodation?

Documentation must be refreshed at least once every 12 months. The university will contact you when a renewal is needed.

Contact Information

If you have questions or need assistance completing the form, please reach out to the Office of Disability Services:

• Email: disabilityservices@university.edu
• Phone: (555) 1234567 (MonFri, 9am5pm)
• Office: 2nd Floor, Student Services Building, Room 210