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Anxiety
You feel
Constant worry, racing heart, can’t sleep, panic in crowds
The dog helps
Dog’s presence lowers heart rate, interrupts spiraling, enables sleep
Get a PSD Letter from a licensed therapist in your state. Fill out a short questionnaire, speak with your assigned clinician, and receive a signed letter by email within 24 hours. Full refund if your landlord doesn’t accept it.
A PSD Letter from realesaletter includes two things: a live consultation call with a licensed therapist assigned to your state, and a signed clinical document delivered by email within 24 hours. Together they establish your eligibility as a psychiatric service dog handler under the Fair Housing Act and the ADA.
The letter makes two clinical statements:
It says nothing about your dog. No breed, no training, no certification.
The live call is what separates a legitimate PSD Letter from a template. realesaletter’s licensed therapists conduct a real clinical consultation, reviewing your history, assessing your condition, and forming an independent professional opinion before any letter is issued. No instant approvals. No automated sign-offs.
Training your dog to perform a specific disability-related task is your separate responsibility as the handler. The letter documents your eligibility. The training is what unlocks full ADA public access rights alongside it.
Not sure whether you need a PSD Letter or an ESA letter? Read our full guide to learn what a PSD letter is and whether you need one.
What you receive for $199
Short, fully online. No in-person visit required.
A real clinical consultation with a credentialed clinician in your state.
Digitally signed PDF delivered within 24 hours of your call.
Physical letter mailed within 3 business days.
The team will liaise with your landlord or housing provider if your letter is questioned.
Getting a PSD Letter online takes four steps: a short questionnaire, a licensed therapist assignment, a live consultation call, and your signed letter delivered within 24 hours.
Short online questionnaire about your mental health condition. Fully online, no in-person visit required.
Your case is assigned to a licensed clinician (LCSW, LMFT, Psychologist, or Psychiatric NP) with active credentials for your state.
Payment collected at booking. Your clinician conducts a live consultation and forms their clinical determination.
Digitally signed PDF by email within 24 hours. Hard copy mailed within 3 business days.
100% refund if your PSD Letter isn’t accepted by your landlord
You may qualify if you have a diagnosed mental health condition that affects your ability to sleep, work, leave the house, or maintain relationships. Your assigned therapist makes the final determination on your consultation call.
Common qualifying conditions include anxiety, depression, PTSD, ADHD, OCD, bipolar disorder, panic disorder, social anxiety, autism spectrum disorder, and schizophrenia.
Constant worry, racing heart, can’t sleep, panic in crowds
Dog’s presence lowers heart rate, interrupts spiraling, enables sleep
Can’t get out of bed, no motivation, isolates from others
Obligation to walk and care for dog breaks the depressive cycle
Flashbacks, nightmares, triggered by sounds, can’t feel safe
Dog grounds handler back to reality during episodes
Sudden terror attacks. Heart pounds, can’t breathe.
Dog’s physical presence interrupts the panic cycle
Extreme mood swings, manic episodes, deep depressive lows
Provides routine and grounding during unstable periods
Intrusive thoughts, repetitive rituals consuming hours daily
Routine care provides structure; task interrupts compulsive cycles
Can’t focus, impulsive, emotional dysregulation, overwhelm
Provides calming anchor and daily routine
Paralysing fear of social situations, avoids public spaces
Dog’s presence enables movement through anxiety-triggering environments
Sensory overload, difficulty reading social cues, meltdowns
Provides sensory grounding and predictable social buffer
Psychotic episodes, auditory hallucinations, disorganised thinking
Provides grounding stimulus and routine that supports stability
To qualify, your dog must also be individually trained to perform at least one specific task directly related to your disability. The letter documents your eligibility. Training is your responsibility and is what unlocks full ADA public access rights.
Only the licensed clinician evaluating your case can determine clinical appropriateness. A condition appearing on this list does not guarantee approval.
A PSD Letter covers everything an ESA letter covers: housing with no pet fees or breed restrictions under the Fair Housing Act. It also documents your eligibility for ADA public access rights and DOT-protected air travel with a task-trained dog, processed by the same licensed therapists in 24 hours for $50 more.
| ESA Letter $149 |
PSD Letter$199
|
|
|---|---|---|
| No pet fees | ✓ | ✓ |
| No breed restrictions | ✓ | ✓ |
| ADA public access with trained dog | — | ✓ |
| Air travel in cabin with trained dog* | — | ✓ |
| Live therapist call included | — | ✓ |
*Air travel also requires the U.S. DOT Service Animal Air Transportation Form. The PSD Letter documents your eligibility. The DOT form must be completed separately. See the air travel FAQ below.
For a detailed side-by-side breakdown, read the full PSD Letter guide.
Housing providers and airlines increasingly know what legitimate PSD documentation looks like. What separates an accepted letter from a rejected one comes down to who signed it and whether that clinician can be verified through state licensing channels.
Every letter follows a live call with a licensed therapist. No instant approvals, no template letters, no automated sign-offs.
The panel includes LCSWs, LMFTs, Psychologists, and Psychiatric NPs with active board licenses or compact authorisation for your state.
Evaluations are conducted under HIPAA standards. Your records are never shared outside your care team or used for any purpose beyond your evaluation.
The team will help you complete DOT air travel forms and liaise directly with your landlord or housing provider if your letter is questioned. No extra charge.
Full refund if your PSD Letter is not accepted by your landlord. No questions asked.
realesaletter’s PSD Letters are accepted by major property-management companies operating across all 50 states, including tenants in accommodation requests with national multifamily operators.
realesaletter’s licensed therapists are available for PSD Letter evaluations in every U.S. state. Each case is assigned to a clinician with active credentials for that state.
30-day waiting period: Your evaluation is assigned to a clinician with active credentials for your specific state. California, Arkansas, Iowa, Louisiana, and Montana have a 30-day waiting period before a letter can be issued.
These are the most common questions about getting a PSD Letter online, answered by realesaletter’s licensed clinical team.
A PSD Letter is a signed clinical document from a licensed mental health professional, issued after a live consultation call, that establishes your eligibility as a psychiatric service dog handler under the Fair Housing Act and the Americans with Disabilities Act. It documents your qualifying condition and your therapist’s clinical opinion that a psychiatric service dog would provide therapeutic benefit. It makes no statement about your dog’s training. That is your responsibility as the handler.
An ESA letter covers housing only, eliminating pet fees and breed restrictions under the Fair Housing Act. A PSD Letter covers housing under the same law and additionally documents your eligibility for ADA public access rights and DOT-protected air travel with a task-trained dog. The PSD process also includes a live therapist call. The ESA letter does not. A PSD Letter costs $50 more ($199 vs $149).
See the full PSD Letter guide for a detailed breakdown of rights, costs, and use cases.
Any DSM-recognised mental health condition that substantially limits a major life activity may qualify, including anxiety, depression, PTSD, panic disorder, bipolar disorder, OCD, ADHD, autism spectrum disorder, social anxiety, and schizophrenia. Eligibility is determined by your therapist on the consultation call. A condition appearing on this list does not guarantee approval.
No. Your dog does not need to be trained before your consultation or before the letter is issued. The letter documents your eligibility as a handler. Training your dog to perform a specific disability-related task is your separate responsibility and is what unlocks ADA public access rights. The ADA allows owner-training. Professional training is not required.
Your assigned licensed therapist conducts a clinical consultation, reviewing your mental health history, assessing your qualifying condition, and forming their professional opinion on whether a psychiatric service dog would provide therapeutic benefit. If they determine you qualify, they issue the signed PSD Letter. If they determine you don’t qualify, you receive a full refund.
Most letters are delivered within 24 hours of the consultation call. A hard copy is mailed within 3 business days. California, Arkansas, Iowa, Louisiana, and Montana require a 30-day client-provider relationship before a letter can be issued. In those states the letter issues 30 days after your initial consultation. realesaletter issues letters within 24 hours of the call in all other 45 states.
A PSD Letter is valid for 12 months from the date of issue. Most housing providers and airlines require documentation issued within the past year. Annual renewal is recommended to keep your documentation current.
When your letter approaches expiration, you can renew your PSD letter through the same process.
A PSD Letter alone is not sufficient for air travel. Airlines also require the U.S. DOT Service Animal Air Transportation Form and, for flights over 8 hours, a relief attestation. With those forms completed and a task-trained dog, your PSD may fly in the cabin. Always verify your specific airline’s current policy before travelling.
Yes. Both are available and they are not mutually exclusive. The ESA + PSD Combo at $249 includes both letters from a single evaluation. Some clients hold both for housing situations where a provider is more familiar with ESA letters. Having both removes any ambiguity.
Compare all pricing options including the ESA + PSD Combo.
No. There is no federal or state registry for psychiatric service dogs, and no registration is recognised or required under the ADA. Services selling PSD registrations, certificates, vest kits, or ID cards are not providing legally meaningful documentation. The only documentation that carries weight for housing and ADA rights is a letter from a licensed mental health professional.
Licensed therapists. Live call. Clinical assessment. Letter delivered within 24 hours. $199 at booking. Full money-back guarantee if it isn’t accepted.
Full refund if your letter isn’t accepted by your landlord. No questions asked.
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