Get Esa Form

Filling out the Esa Form online is an essential step for students seeking an emotional support animal. This guide will walk you through the process, ensuring that you provide all necessary information accurately and efficiently.

Follow the steps to complete the Esa Form online.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred digital editor.
2. Complete the student information section by providing your name, date, signed consent, university student number, and contact information such as phone number and email.
3. In the animal information section, enter the name, type, breed, and age of your emotional support animal.
4. The next section requires the certification from a licensed clinical professional. Ensure this is filled out by someone who is not a relative and is familiar with your situation.
5. The certifying professional must print their name, provide their address, credentials, state, zip code, and licensure information.
6. This professional must also indicate how long they have treated or counseled you, including the dates of initial contact and the last office visit.
7. The form requires the professional to specify your disability or disorder using DSM-V criteria, describing symptoms, limitations, and how they affect major life activities.
8. Answer whether the animal is specifically prescribed for treatment and how it will affect your symptoms.
9. Discuss whether the responsibilities of caring for an animal may exacerbate your symptoms.
10. Finally, ensure the form is signed by the certifying professional and includes their email address.
11. After completing the form, you can save changes, download, print, or share the document as needed.

Take the first step and fill out the Esa Form online today.