Emotional Support Animal Policy

Effective Date: 11/01/2025
Review Date: 11/01/2025

Purpose

The purpose of this policy is to outline Prism Family Medicine’s approach to requests for Emotional Support Animal (ESA) letters. This policy ensures that ESA letters are issued in a clinically appropriate and ethically responsible manner, consistent with professional standards and the provider’s clinical judgment.

Policy

Patients requesting ESA letters from Prism Family Medicine must schedule an appointment with their primary care provider for evaluation. Providers will review the patient’s medical record, treatment history, and current mental health status. If clinically appropriate, the provider may issue a letter for Emotional Support Animals, noting a one-year expiration date. A copy of the letter must be retained in the patient’s chart. Renewal requests must follow the same evaluation and documentation process. Issuance of an ESA letter by Prism Family Medicine does not constitute an assessment or guarantee of the patient’s ability to care for an animal, nor does it imply clinic responsibility for the patient’s actions or the animal’s behavior.

  1. Provider Discretion:
    The decision to provide an ESA letter is at the sole discretion of the patient’s licensed healthcare provider. A request for an ESA letter does not guarantee that one will be provided. Providers are under no obligation to complete or endorse ESA documentation if, in their professional judgment, it is not clinically indicated.

  2. Established Patient Requirement:
    ESA letters may only be considered for patients who are established at Prism Family Medicine, with the clinic managing their ongoing primary care.

  3. Mental Health Documentation:
    The patient’s medical record must include documented evidence of a qualifying mental health condition, as well as active treatment or management of that condition by a Prism Family Medicine provider.

  4. Assessment and Documentation:
    Prior to issuance, the provider must evaluate whether the requested ESA support is appropriate and supported by the patient’s treatment history and current clinical presentation. This assessment must be documented in the patient’s medical record.

  5. Letter Expiration and Renewal:
    ESA letters issued by Prism Family Medicine are valid for one (1) year from the date of issuance. Renewal requires a follow-up evaluation and updated documentation to confirm continued clinical indication and treatment engagement.

  6. Third-Party Requests:
    Prism Family Medicine does not guarantee completion of ESA-related forms or letters requested by third parties (e.g., landlords, schools, or employers). Providers reserve the right to decline such requests if they fall outside the scope of established care or clinical appropriateness.