An emotional support animal letter is a clinical assessment, not a favor — and since January 2021 it does nothing for air travel. Two hosts cover what HUD actually accepts from a treating clinician with personal knowledge of the patient, why you don't have to disclose a diagnosis to write one, and the script for declining when the assessment doesn't support the request. Full script: https://psychnpfellowship.com/esa-letter-request-pmhnp-confidence-script-2026/